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
- NPI
- Entity Type Code
- Employer Identification Number EIN
- Provider Organization Name Legal Business Name
- Provider Other Organization Name
- Provider Other Organization Name Type Code
- Provider First Line Business Mailing Address
- Provider Business Mailing Address City Name
- Provider Business Mailing Address State Name
- Provider Business Mailing Address Postal Code
- Provider Business Mailing Address Country Code If outside U S
- Provider Business Mailing Address Telephone Number
- Provider Business Mailing Address Fax Number
- Provider First Line Business Practice Location Address
- Provider Business Practice Location Address City Name
- Provider Business Practice Location Address State Name
- Provider Business Practice Location Address Postal Code
- Provider Business Practice Location Address Country Code If outside U S
- Provider Business Practice Location Address Telephone Number
- Provider Business Practice Location Address Fax Number
- Provider Enumeration Date
- Last Update Date
- Authorized Official Last Name
- Authorized Official First Name
- Authorized Official Middle Name
- Authorized Official Title or Position
- Authorized Official Telephone Number
- Healthcare Provider Taxonomy Code 1
- Provider License Number 1
- Provider License Number State Code 1
- Healthcare Provider Primary Taxonomy Switch 1
- Other Provider Identifier 1
- Other Provider Identifier Type Code 1
- Other Provider Identifier State 1
- Other Provider Identifier Issuer 1
- Other Provider Identifier 2
- Other Provider Identifier Type Code 2
- Other Provider Identifier State 2
- Other Provider Identifier Issuer 2
- Other Provider Identifier 3
- Other Provider Identifier Type Code 3
- Other Provider Identifier State 3
- Other Provider Identifier Issuer 3
- Other Provider Identifier 4
- Other Provider Identifier Type Code 4
- Other Provider Identifier State 4
- Is Organization Subpart
- 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.
- Provider Organization Name Legal Business Name: ASSOCIATED HEALTH SERVICES
- 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).
- The date that a record was last updated or changed.
- The first name of the authorized official.
- The middle name of the authorized official.
- The title or position of the authorized official.
- 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