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  7. NPI Record 1467874164

JAMES E DAVIS AMBULATORY SURGICAL CENTER
Complete NPI Record 1467874164
Clinic/Center - Ambulatory Surgical in Durham, NC

NPI Status: Active since January 15, 2014

Contact Information

120 E CARVER ST
DURHAM, NC
ZIP 27704
Phone: (919) 470-1000
Fax: (919) 470-1053

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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 Business Mailing Address Fax Number
  14. Provider First Line Business Practice Location Address
  15. Provider Business Practice Location Address City Name
  16. Provider Business Practice Location Address State Name
  17. Provider Business Practice Location Address Postal Code
  18. Provider Business Practice Location Address Country Code If outside U S
  19. Provider Business Practice Location Address Telephone Number
  20. Provider Business Practice Location Address Fax Number
  21. Provider Enumeration Date
  22. Last Update Date
  23. Authorized Official Last Name
  24. Authorized Official First Name
  25. Authorized Official Middle Name
  26. Authorized Official Title or Position
  27. Authorized Official Telephone Number
  28. Healthcare Provider Taxonomy Code 1
  29. Provider License Number 1
  30. Provider License Number State Code 1
  31. Healthcare Provider Primary Taxonomy Switch 1
  32. Other Provider Identifier 1
  33. Other Provider Identifier Type Code 1
  34. Other Provider Identifier State 1
  35. Other Provider Identifier Issuer 1
  36. Other Provider Identifier 2
  37. Other Provider Identifier Type Code 2
  38. Other Provider Identifier State 2
  39. Other Provider Identifier Issuer 2
  40. Other Provider Identifier 3
  41. Other Provider Identifier Type Code 3
  42. Other Provider Identifier State 3
  43. Other Provider Identifier Issuer 3
  44. Other Provider Identifier 4
  45. Other Provider Identifier Type Code 4
  46. Other Provider Identifier State 4
  47. Is Organization Subpart
  48. NPI Certification Date

Complete NPI Dataset

This page represents the complete record for NPI 1467874164. 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: 1467874164
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: 2
The abbreviations for professional degrees or credentials used or held by the provider, if the provider is an individual. Examples are MD, DDS, CSW, CNA, AA, NP, RNA, or PSY. These credential designations will not be verified by NPS.
Employer Identification Number EIN: UNAVAIL
Other last name by which the provider being identified is or has been known.
Other first name by which the provider being identified is or has been known (if an individual). This may be the same as the ‘‘Provider first name’’ if the provider is or has been known by a different last name only.
Provider Other Organization Name: JAMES E DAVIS AMBULATORY SURGICAL CENTER
Code 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 Other Organization Name Type Code: 3
Code 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 Address: PO BOX 110566
The first line mailing address of the provider being identified. This data element may contain the same information as ‘‘Provider first line location address’’.
Provider Business Mailing Address City Name: DURHAM
The first line mailing address of the provider being identified. This data element may contain the same information as ‘‘Provider first line location address’’.
Provider Business Mailing Address State Name: NC
The 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 Code: 277095566
The 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 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: 9196204855
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 Fax Number: 9196204921
The 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 Address: 120 E CARVER ST
The 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 Business Practice Location Address City Name: DURHAM
The city name in the location address of the provider being identified.
Provider Business Practice Location Address State Name: NC
The State code in the location of the provider being identified.
Provider Business Practice Location Address Postal Code: 277042700
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: 9194701000
The country code in the location address of the provider being identified.
Provider Business Practice Location Address Fax Number: 9194701053
The telephone number associated with the location address of the provider being identified.
Provider Enumeration Date: 1/15/2014
The fax number associated with the location address of the provider being identified.
Last Update Date: 9/12/2023
The date the provider was assigned a unique identifier (assigned an NPI).
Authorized Official Last Name: SMITH
The date that a record was last updated or changed.
Authorized Official First Name: JOHN
The first name of the authorized official.
Authorized Official Middle Name: STUART
The middle name of the authorized official.
Authorized Official Title or Position: VP, FINANCE
The title or position of the authorized official.
Authorized Official Telephone Number: 9196138995
The 10-position telephone number of the authorized official.
Healthcare Provider Taxonomy Code 1: 261QA1903X
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 1: AS0041
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 License Number State Code 1: NC
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
Other Provider Identifier 1: 6850203
Additional 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 1: 01
Code indicating whether the provider is operating as a sole proprietor. Codes are: Y = Yes; N = No
Other Provider Identifier State 1: NC
Other Provider Identifier Issuer 1: UNITED HEALTH CARE
Other Provider Identifier 2: 00679
Additional 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 2: 01
Code 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 2: NC
Other Provider Identifier Issuer 2: STATE HEALTH PLAN
Other Provider Identifier 3: 00679
Additional 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 3: 01
Code 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 3: NC
Other Provider Identifier Issuer 3: BLUE CROSS BLUE SHIELD OF NC
Other Provider Identifier 4: 3409921
Additional 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 4: 05
Code 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 4: NC
Is Organization Subpart: N
NPI Certification Date: 9/12/2023