1689001802 NPI number — MRS. SARA ROSE BILLE CNP

Table of content: MRS. SARA ROSE BILLE CNP (NPI 1689001802)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1689001802 NPI number — MRS. SARA ROSE BILLE CNP

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
BILLE
Provider First Name:
SARA
Provider Middle Name:
ROSE
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
CNP
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1689001802
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/29/2024
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 269084
Provider Second Line Business Mailing Address:
DEPT 1102
Provider Business Mailing Address City Name:
OKLAHOMA CITY
Provider Business Mailing Address State Name:
OK
Provider Business Mailing Address Postal Code:
73126
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
731-394-1145
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
4466 LYNNHAVEN AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
LOUISVILLE
Provider Business Practice Location Address State Name:
OH
Provider Business Practice Location Address Postal Code:
44641-9513
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
731-394-1145
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
10/02/2013

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 363LF0000X , with the licence number:  15143-NP , registered in the state of OH ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 0096127 , issued by the state of ( OH ) . This identifiers is of the category "MEDICAID".
  • Identifier: 9338635 . This is a "PARTNERS PHYSICIAN GROUP MEDICARE GROUP #" identifier , issued by the state of ( OH ) . This identifiers is of the category "OTHER".
  • Identifier: 1992139274 . This is a "PARTNERS PHYSICIAN GROUP TYPE 2 NPI - URGENT CARES" identifier , issued by the state of ( OH ) . This identifiers is of the category "OTHER".
  • Identifier: 0091231 . This is a "PARTNERS PHYSICIAN GROUP MEDICAD GROUP # - URGENT CARES" identifier , issued by the state of ( OH ) . This identifiers is of the category "OTHER".




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