JOHN MAXWELL ISENHOUR-BURLAKE
Complete NPI Record 1215693775
Rehabilitation Practitioner in Pahrump, NV

NPI Status: Active since November 09, 2021

Contact Information

1601 E BASIN AVE STE 303
PAHRUMP, NV
ZIP 89060
Phone: (775) 537-8898

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Complete NPI Dataset

This page represents the complete record for NPI 1215693775. 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: 1215693775
The 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 Code: 1
Code 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).
Code 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).
Provider First Name: JOHN
The first name of the provider, if the provider is an individual.
Provider Middle Name: MAXWELL
The middle name of the provider, if the provider is an individual.
Provider First Line Business Mailing Address: 3400 RODEO AVE
The middle name of the provider, if the provider is an individual.
Provider Business Mailing Address City Name: PAHRUMP
The city name in the mailing address of the provider being identified.
Provider Business Mailing Address State Name: NV
The city name in the mailing address of the provider being identified.
Provider Business Mailing Address Postal Code: 890487045
The 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 : US
The 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 Telephone Number: 7755134433
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: 1601 E BASIN AVE STE 303
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 Business Practice Location Address City Name: PAHRUMP
The city name in the location address of the provider being identified.
Provider Business Practice Location Address State Name: NV
The city name in the location address of the provider being identified.
Provider Business Practice Location Address Postal Code: 890604612
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 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 Telephone Number: 7755378898
The telephone number associated with the location address of the provider being identified.
Provider Enumeration Date: 11/9/2021
The telephone number associated with the location address of the provider being identified.
Last Update Date: 11/9/2021
The date that a record was last updated or changed.
Provider Gender Code: M
The date that a record was last updated or changed.
Healthcare Provider Taxonomy Code 1: 225400000X
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.
Healthcare Provider Primary Taxonomy Switch 1: Y
Is Sole Proprietor: Y
Code indicating whether the provider is operating as a sole proprietor. Codes are: Y = Yes; N = No
NPI Certification Date: 10/19/2021
Code indicating whether the provider is operating as a sole proprietor. Codes are: Y = Yes; N = No