| Name | Description | Type | Additional information |
|---|---|---|---|
| NPI | string |
None. |
|
| FirstName | string |
None. |
|
| LastName | string |
None. |
|
| Address1 | string |
None. |
|
| Address2 | string |
None. |
|
| City | string |
None. |
|
| State | string |
None. |
|
| ZIP | string |
None. |
|
| Phone | string |
None. |
|
| Fax | string |
None. |
|
| string |
None. |
||
| Specialty | string |
None. |
|
| inactive | boolean |
None. |
|
| Upin | string |
None. |
|
| PatientId | string |
None. |
|
| ProviderReference | string |
None. |