_id |
ENROLLMENT ID |
ENROLLMENT STATE |
PROVIDER TYPE CODE |
PROVIDER TYPE TEXT |
NPI |
MULTIPLE NPI FLAG |
CCN |
ASSOCIATE ID |
ORGANIZATION NAME |
DOING BUSINESS AS NAME |
INCORPORATION DATE |
INCORPORATION STATE |
ORGANIZATION TYPE STRUCTURE |
ORGANIZATION OTHER TYPE TEXT |
PROPRIETARY_NONPROFIT |
ADDRESS LINE 1 |
ADDRESS LINE 2 |
CITY |
STATE |
ZIP CODE |
PRACTICE LOCATION TYPE |
LOCATION OTHER TYPE TEXT |
colspacer |
|
ENROLLMENT ID |
ENROLLMENT STATE |
PROVIDER TYPE CODE |
PROVIDER TYPE TEXT |
NPI |
MULTIPLE NPI FLAG |
CCN |
ASSOCIATE ID |
ORGANIZATION NAME |
DOING BUSINESS AS NAME |
INCORPORATION DATE |
INCORPORATION STATE |
ORGANIZATION TYPE STRUCTURE |
ORGANIZATION OTHER TYPE TEXT |
PROPRIETARY_NONPROFIT |
ADDRESS LINE 1 |
ADDRESS LINE 2 |
CITY |
STATE |
ZIP CODE |
PRACTICE LOCATION TYPE |
LOCATION OTHER TYPE TEXT |
|
Data last updated: June 18, 2025, 21:17 (UTC)
Metadata last updated: June 18, 2025, 21:17 (UTC)
Created: June 18, 2025, 21:17 (UTC)
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