NPPES organizational identifier and taxonomy
Not established
This fact is not currently established by the evidence in this record.
The dated CMS NPPES V.2 bulk snapshot through September 27, 2026. A match requires an exact normalized organization legal name or officially reported DBA, exact full practice street and city/state, and an active Type 2 NPI record in the latest available release. NPPES data are provider-reported; NPI assignment and taxonomy do not establish state licensure, credentialing, quality, insurance participation, or that a location is currently operating.
The previous match is withdrawn from supported results. The directory record does not disclose the suite/unit shown in the CMS NPPES practice address, so the full practice location cannot be confirmed as the same location under the exact-address rule. No NPI identity is established by this evidence. CMS NPPES data are provider-reported and do not establish licensure, credentialing, quality, insurance participation, or current operation.
- CMS NPPES provider record 1417675372 · Source observed 2026-10-01
- CMS NPPES V.2 monthly and weekly downloadable files · Source observed 2026-10-01
Reviewed 2026-10-01 · Review due 2026-10-31 · Version 2