NPI Number | 1376146258 |
Provider Name | Isaac Alvis |
Credential | |
Specialization | |
Medical School Name | |
Graduation Year | |
Gender | |
Entity Type | Individual |
PAC ID by PECOS | |
Professional Enrollment ID | |
Enumeration Date | 11/21/2020 |
Last Update Date | 11/21/2020 |
Business Practice address |
3317 MARAIS ST, New Orleans, 70117-6117 Louisiana View on Google Map |
Business Practice phone | 504-710-5339 |
Business Practice fax | |
Mailing address |
3317 MARAIS ST, New Orleans, 70117-6117 Louisiana View on Google Map |
Other phone | 504-710-5339 |
Other fax | |
Email Address | shannonfig@domain.com Reval Email Address |
New Orleans, Louisiana
Field Name | Field Value |
---|---|
NPI | 1376146258 |
10-position all-numeric identification number assigned by the NPS to uniquely identify a health care provider. | |
Entity Type | Individual |
Code describing the type of health care provider that is being assigned an NPI. Codes are:
|
|
Is Sole Proprietor | Y |
Indicate whether provider is a sole proprietor.
|
|
Provider Last Name (Legal Name) | Alvis |
The last name of the provider (if an individual). If the provider is an individual, this is the legal name. This name must match the name on file with the Social Security Administration (SSA). In addition, the date of birth must match that on file with SSA. (First and last names are required for initial applications.) The First, Middle, Last and Credential(s) fields allow the following special characters: ampersand, apostrophe, colon, comma, forward slash, hyphen, left and right parentheses, period, pound sign, quotation mark, and semi-colon. A field cannot contain all special characters. | |
Provider First Name | Isaac |
The first name of the provider, if the provider is an individual. | |
Provider Credential Text | |
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. | |
Provider First Line Business Mailing Address | 3317 MARAIS ST |
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 | New Orleans |
The City name in the mailing address of the provider being identified. This data element may contain the same information as ''Provider location address City name''. | |
Provider Business Mailing Address State Name | Louisiana |
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 | 70117-6117 |
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 | 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 | 504-710-5339 |
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 | 3317 MARAIS ST |
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 | New Orleans |
The city name in the location address of the provider being identified. | |
Provider Business Practice Location Address State Name | Louisiana |
The State or Province name in the location address of the provider being identified. | |
Provider Business Practice Location Address Postal Code | 70117-6117 |
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 | US |
The country code in the location address of the provider being identified. | |
Provider Business Practice Location Address Telephone Number | 504-710-5339 |
The telephone number associated with the location address of the provider being identified. | |
Provider Enumeration Date | 11/21/2020 |
The date the provider was assigned a unique identifier (assigned an NPI). | |
Last Update Date | 11/21/2020 |
The date that a record was last updated or changed. | |
Healthcare Provider Taxonomy Code #1 | 251X00000X |
The Health Care Provider Taxonomy code is a unique alphanumeric code, ten characters in length. The code set is structured into three distinct "Levels" including Provider Type, Classification, and Area of Specialization. | |
Healthcare Provider Taxonomy 1 | A provider of service/function that assists participating individuals to make informed decisions about what will work best for them is consistent with their needs and reflects their individual circumstances. Serving as the agent of the individual, the service is available to assist in identifying immediate and long-term needs, developing options to meet those needs and accessing identified supports and services and may include assistance with recruiting, screening, hiring, and training in-home support providers. A family or person-centered planning approach is used. Supports Brokerage offers practical skills training to enable families and individuals to remain independent. Examples of skills training include providing information on recruiting and hiring personal care workers, managing personal care workers and providing information on effective communication and problem solving. The service/function provides sufficient information to assure that individuals understand the responsibilities involved with self-direction and assist in the development of an effective back-up and emergency plan. Plans may elect to fulfill the requirement of this service/function using a self-directed case manager or creating a distinct service. The Supports Brokerage documents the need for assistive services, planning for and documenting the use of excess funds and locating and maintaining services. |
Healthcare Provider Taxonomy #1 | |
Healthcare Provider Primary Taxonomy Switch 1 | Y |
Primary Taxonomy:
|