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VITUITY
Complete NPI Record 1184997645
Emergency Medicine in Clovis, CA

NPI Status: Active since February 14, 2012

Contact Information

2755 HERNDON AVE
CLOVIS, CA
ZIP 93611
Phone: (559) 324-4000

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Table of Contents

  1. NPI
  2. Entity Type Code
  3. Employer Identification Number EIN
  4. Provider Organization Name Legal Business Name
  5. Provider Other Organization Name
  6. Provider Other Organization Name Type Code
  7. Provider First Line Business Mailing Address
  8. Provider Business Mailing Address City Name
  9. Provider Business Mailing Address State Name
  10. Provider Business Mailing Address Postal Code
  11. Provider Business Mailing Address Country Code If outside U S
  12. Provider Business Mailing Address Telephone Number
  13. Provider First Line Business Practice Location Address
  14. Provider Business Practice Location Address City Name
  15. Provider Business Practice Location Address State Name
  16. Provider Business Practice Location Address Postal Code
  17. Provider Business Practice Location Address Country Code If outside U S
  18. Provider Business Practice Location Address Telephone Number
  19. Provider Enumeration Date
  20. Last Update Date
  21. Authorized Official Last Name
  22. Authorized Official First Name
  23. Authorized Official Title or Position
  24. Authorized Official Telephone Number
  25. Healthcare Provider Taxonomy Code 1
  26. Provider License Number State Code 1
  27. Healthcare Provider Primary Taxonomy Switch 1
  28. Is Organization Subpart
  29. Authorized Official Credential Text
  30. Healthcare Provider Taxonomy Group 1
  31. NPI Certification Date

Complete NPI Dataset

This page represents the complete record for NPI 1184997645. You can access the complete dataset, including a full list of field names, along with their values, and definitions as recorded by the NPI registry. Each field in the NPI record is explained, highlighting its significance and the possible values it can hold.

NPI: 1184997645
The country code in the location address of the provider being identified.
Entity Type Code: 2
The telephone number associated with the location address of the provider being identified.
Employer Identification Number EIN: UNAVAIL
The fax number associated with the location address of the provider being identified.
The date the provider was assigned a unique identifier (assigned an NPI).
Provider Other Organization Name: VITUITY
The date that a record was last updated or changed.
Provider Other Organization Name Type Code: 3
The code designating the provider’s gender if the provider is a person.
Provider First Line Business Mailing Address: 1601 CUMMINS DR STE D
Code 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 Business Mailing Address City Name: MODESTO
The 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 Business Mailing Address State Name: CA
The 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.
Provider Business Mailing Address Postal Code: 953586411
Provider Business Mailing Address Country Code If outside U S : US
The 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 Number: 5103502600
The 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 First Line Business Practice Location Address: 2755 HERNDON AVE
The 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 Business Practice Location Address City Name: CLOVIS
The city name in the location address of the provider being identified.
Provider Business Practice Location Address State Name: CA
The State code in the location of the provider being identified.
Provider Business Practice Location Address Postal Code: 936116800
The 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 : US
The country code in the location address of the provider being identified.
Provider Business Practice Location Address Telephone Number: 5593244000
The telephone number associated with the location address of the provider being identified.
Provider Enumeration Date: 2/14/2012
The date the provider was assigned a unique identifier (assigned an NPI).
Last Update Date: 3/19/2020
The date that a record was last updated or changed.
Authorized Official Last Name: BIRDSALL
The last name of the person authorized to submit the NPI application or to change NPS data for a health care provider.
Authorized Official First Name: DAVID
The first name of the authorized official.
Authorized Official Title or Position: CHIEF OPERATIONS OFFICER
The title or position of the authorized official.
Authorized Official Telephone Number: 5103502600
The 10-position telephone number of the authorized official.
Healthcare Provider Taxonomy Code 1: 207P00000X
Code 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 State Code 1: CA
The 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 1: Y
Is Organization Subpart: N
Authorized Official Credential Text: MD
Healthcare Provider Taxonomy Group 1: 193200000X MULTI-SPECIALTY GROUP
NPI Certification Date: 3/19/2020