Provider Name : {{npiStatusValues.provider_First_Name}}
{{npiStatusValues.provider_Middle_Name}}
{{npiStatusValues.provider_Last_Name}}
{{npiStatusValues.organization_Name}}
NPI: |
{{npiStatusValues.npi}} |
NPI Status: |
{{npiStatusValues.npistatus}} |
Application Receipt Date: |
{{npiStatusValues.rqstRcptDtStr}} |
Tracking ID: |
{{npiStatusValues.prvdr_trkng_id}} |
NPI Status Reason: |
{{npiStatusValues.npistatusReason}} |
|
Enumeration Date: |
{{npiStatusValues.enmrtnDateStr}} |
Entity Type: |
{{npiStatusValues.prvdr_ent_type_rfrnc_cd}} |
Receipt Method: |
{{npiStatusValues.appRcptMthd}} |
Last Modified Date: |
{{npiStatusValues.updateTsStr}} |
|
|
|
|
Certification Date: |
{{npiStatusValues.certificationTsStr}} |