NPI Record of MARSHALL MEDICAL CENTER SOUTH NPI 1992967772

Emergency Medicine in Boaz, AL

Complete NPI Record

Field Name Value Definition
NPI1992967772The 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 NameMARSHALL MEDICAL CENTER SOUTHThe name of the organization provider. If the provider is an organization, this is the legal business name.
Provider First Line Business Mailing Address2505 US HWY 431 NThe 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 NameBOAZThe city name in the mailing address of the provider being identified.
Provider Business Mailing Address State NameALThe 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 Code35957The 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 Number2565938310The 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 Address2505 US HWY 431 NThe 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 NameBOAZThe city name in the location address of the provider being identified.
Provider Business Practice Location Address State NameALThe State code in the location of the provider being identified.
Provider Business Practice Location Address Postal Code35957The 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 Number2565938310The telephone number associated with the location address of the provider being identified.
Provider Enumeration Date7/2/2008The date the provider was assigned a unique identifier (assigned an NPI).
Last Update Date7/2/2008The date that a record was last updated or changed.
Authorized Official Last NameNELSONThe last name of the person authorized to submit the NPI application or to change NPS data for a health care provider.
Authorized Official First NameKATHYThe first name of the authorized official.
Authorized Official Middle NameBThe middle name of the authorized official.
Authorized Official Title or PositionCHIEF FINANCIAL OFFICERThe title or position of the authorized official.
Authorized Official Telephone Number2568946600The 10-position telephone number of the authorized official.
Healthcare Provider Taxonomy Code 1207Q00000XCode 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 1N
Healthcare Provider Taxonomy Code 2207R00000X
Healthcare Provider Primary Taxonomy Switch 2N
Healthcare Provider Taxonomy Code 3282N00000X
Provider License Number State Code 3ALThe 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 3N
Healthcare Provider Taxonomy Code 4207P00000X
Healthcare Provider Primary Taxonomy Switch 4Y
Other Provider Identifier 1558200290Additional 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 1AL
Is Organization SubpartY
Parent Organization LBNMARSHALL MEDICAL CENTER SOUTH
Parent Organization TINUNAVAIL
Authorized Official Name Prefix TextMS.
Authorized Official Credential TextCPA
Healthcare Provider Taxonomy Group 1193200000X MULTI-SPECIALTY GROUP
Healthcare Provider Taxonomy Group 2193200000X MULTI-SPECIALTY GROUP
Healthcare Provider Taxonomy Group 4193200000X MULTI-SPECIALTY GROUP