WAYAH INTERNAL MEDICINE
Complete NPI Record 1003014770
Internal Medicine in Franklin, NC

NPI Status: Active since July 04, 2007

Contact Information

55 MEDICAL PARK DR
SUITE 116
FRANKLIN, NC
ZIP 28734
Phone: (828) 349-6881
Fax: (828) 349-6885

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Complete NPI Dataset

The following table represents the complete dataset for NPI number 1003014770. The table includes a list of all field names, values and definitions of the full NPI record. This dataset is available for download in CSV format using the "Download NPI" button below at the end of the table.

Name Value Definition
NPI1003014770The 10-position all-numeric identification number assigned by the NPS to uniquely identify a health care provider. The NPI number includes an ISO standard check-digit in the 10th position. There is no intelligence about the health care provider in the number.
Entity Type Code2Code describing the type of health care provider that is being assigned an NPI. Codes are 1 = (Person): individual human being who furnishes health care; 2 = (Non-person): entity other than an individual human being that furnishes health care (for example, hospital, SNF, hospital subunit, pharmacy, or HMO).
Employer Identification Number EINUNAVAILThe Employer Identification Number (EIN), assigned by the IRS, of the provider being identified.
Provider Organization Name Legal Business NameKRISHNA INTERNAL MEDICINE, P.C.The name of the organization provider. If the provider is an organization, this is the legal business name.
Provider Other Organization NameWAYAH INTERNAL MEDICINEOther name by which the organization provider is or has been known.
Provider Other Organization Name Type Code3Code identifying the type of other name. Codes are: 1 = former name; 2 = professional name; 3 = doing business as (d/b/ a) name; 4 = former legal business name; 5 = other.
Provider First Line Business Mailing Address55 MEDICAL PARK DRThe first line mailing address of the provider being identified. This data element may contain the same information as ‘‘Provider first line location address’’.
Provider Second Line Business Mailing AddressSUITE 116The second line mailing address of the provider being identified. This data element may contain the same information as ‘‘Provider second line location address’’.
Provider Business Mailing Address City NameFRANKLINThe city name in the mailing address of the provider being identified.
Provider Business Mailing Address State NameNCThe State or Province name in the mailing address of the provider being identified. This data element may contain the same information as ‘‘Provider location address State name’’.
Provider Business Mailing Address Postal Code287342635The postal ZIP or zone code in the mailing address of the provider being identified. NOTE: ZIP code plus 4-digit extension, if available. This data element may contain the same information as ‘‘Provider location address postal code’’.
Provider Business Mailing Address Country Code If outside U S USThe country code in the mailing address of the provider being identified. This data element may contain the same information as ‘‘Provider location address country code’’.
Provider Business Mailing Address Telephone Number8283496881The telephone number associated with mailing address of the provider being identified. This data element may contain the same information as ‘‘Provider location address telephone number’’.
Provider Business Mailing Address Fax Number8283496885The fax number associated with the mailing address of the provider being identified. This data element may contain the same information as ‘‘Provider location address fax number’’.
Provider First Line Business Practice Location Address55 MEDICAL PARK DRThe first line location address of the provider being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box.
Provider Second Line Business Practice Location AddressSUITE 116The second line location address of the provider being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box.
Provider Business Practice Location Address City NameFRANKLINThe city name in the location address of the provider being identified.
Provider Business Practice Location Address State NameNCThe State code in the location of the provider being identified.
Provider Business Practice Location Address Postal Code287342635The postal ZIP or zone code in the location address of the provider being identified. NOTE: ZIP code plus 4-digit extension, if available.
Provider Business Practice Location Address Country Code If outside U S USThe country code in the location address of the provider being identified.
Provider Business Practice Location Address Telephone Number8283496881The telephone number associated with the location address of the provider being identified.
Provider Business Practice Location Address Fax Number8283496885The fax number associated with the location address of the provider being identified.
Provider Enumeration Date7/4/2007The date the provider was assigned a unique identifier (assigned an NPI).
Last Update Date12/28/2011The date that a record was last updated or changed.
Authorized Official Last NameARUWANIThe last name of the person authorized to submit the NPI application or to change NPS data for a health care provider.
Authorized Official First NameVERSIThe first name of the authorized official.
Authorized Official Middle NameMALThe middle name of the authorized official.
Authorized Official Title or PositionPRESIDENTThe title or position of the authorized official.
Authorized Official Telephone Number8283496881The 10-position telephone number of the authorized official.
Healthcare Provider Taxonomy Code 1207R00000XCode designating the provider type, classification, and specialization. Codes are from the Healthcare Provider Taxonomy code list. The NPS will associate these data with the license data for providers with Entity type code = 1.
Provider License Number 1200001557The license number issued to the provider being identified. The NPS can accommodate multiple license numbers for multiple specialties and for multiple States. The NPS will associate this data element with ‘‘provider taxonomy code’’.
Provider License Number State Code 1NCThe code representing the State that issued the license to the provider being identified. This field can accommodate multiple States. It is associated with ‘‘provider license number.
Healthcare Provider Primary Taxonomy Switch 1Y
Other Provider Identifier 189136Y4Additional number currently or formerly used as an identifier for the provider being identified. This data element will be captured from the NPI application/update form.
Other Provider Identifier Type Code 105Code indicating the type of identifier currently or formerly used by the provider being identified. The codes may reflect UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers. This data element will be captured from the NPI application/update form.
Other Provider Identifier State 1NC
Is Organization SubpartN
Authorized Official Name Prefix TextDR.
Authorized Official Credential TextM.D.
Healthcare Provider Taxonomy Group 1193400000X SINGLE SPECIALTY GROUP