JEREMY ROSS M.ED., NPI 1063886950 — LOS ANGELES (CA)

NPI 1063886950

4+ Years Experience Individual

JEREMY ROSS M.ED.

11/16/2015
PROVIDER ENUMERATION DATE
11/16/2015
LAST UPDATE DATE
1063886950
NPI NUMBER

About JEREMY ROSS

Sole proprietor? No, Entity Type 1 Provider (Individual) is not a Sole Proprietor.

JEREMY ROSS is a provider established in LOS ANGELES, CA. The NPI number of JEREMY ROSS is 1063886950 and was assigned on 11/16/2015. The practitioners primary taxonomy code is: 224Y00000X .

Mailing address

  • City: LOS ANGELES
  • State: CA
  • Postal code: 900245434
  • Phone: 3104783711
  • Address: 1409 MIDVALE AVE APT 204

Primary Practice Address

  • Region : LOS ANGELES, CA
  • NPI : 1063886950
  • Phone : 3104783711
  • Postalcode : 900731003
  • Address : 11301 WILSHIRE BLVD

Provider taxonomy - Clinical Exercise Physiologist

  • Taxonomy code: 224Y00000X

The taxonomy is the primary taxonomy (there can be only one per NPI record).

Taxonomy description: A Clinical Exercise Physiologist is a health care professional who is trained to work with patients with chronic disease where exercise training has been shown to be of therapeutic benefit, including but not limited to cardiovascular and pulmonary disease, and metabolic disorders.

Contacts:

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  • JEREMY ROSS M.ED.
  • Address : 11301 WILSHIRE BLVD
  • Region : LOS ANGELES, CA
  • NPI : 1063886950
  • Phone : 3104783711
  • Postalcode : 900731003

Reference NPI Information. Full replica of the CMS (NPPES) NPI record

Field Name Value
Provider First Line Business Practice Location Address11301 WILSHIRE BLVD
The first line location address of the provider being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box.
Provider Business Practice Location Address City NameLOS ANGELES
The city name in the location address of the provider being identified.
Provider Business Practice Location Address State NameCA
The State or Province name in the location address of the provider being identified.
Provider Business Practice Location Address Postal Code900731003
The postal ZIP or zone code in the location address of the provider being identified. NOTE: ZIP code plus 4-digit extension, if available.
Provider Business Practice Location Address Telephone Number3104783711
The telephone number associated with the location address of the provider being identified.
NPI1063886950
10-position all-numeric identification number assigned by the NPS to uniquely identify a health care provider.
Healthcare Provider Taxonomy 1224Y00000X
A Clinical Exercise Physiologist is a health care professional who is trained to work with patients with chronic disease where exercise training has been shown to be of therapeutic benefit, including but not limited to cardiovascular and pulmonary disease, and metabolic disorders.
Provider Enumeration Date11/16/2015
The date the provider was assigned a unique identifier (assigned an NPI).
Last Updated11/16/2015
The date that a record was last updated or changed.
Entity TypeIndividual
Code describing the type of health care provider that is being assigned an NPI. Codes are:
  • 1 = (Person): individual human being who furnishes health care;
  • 2 = (Non-person): entity other than an individual human being that furnishes health care (for example, hospital, SNF, hospital subunit, pharmacy, or HMO).
Provider Organization Name (Legal Business Name)JEREMY ROSS
Provide organization name (legal business name used to file tax returns with the IRS). The Organization Name field allows the following special characters: ampersand, apostrophe, "at" sign, colon, comma, forward slash, hyphen, left and right parentheses, period, pound sign, quotation mark, and semi-colon. A field cannot contain all special characters.
Provider First Line Business Mailing Address1409 MIDVALE AVE APT 204
The first line mailing address of the provider being identified. This data element may contain the same information as "Provider first line location address".
Provider Business Mailing Address City NameLOS ANGELES
The City name in the mailing address of the provider being identified. This data element may contain the same information as "Provider location address City name".
Provider Business Mailing Address State NameCA
The State or Province name in the mailing address of the provider being identified. This data element may contain the same information as "Provider location address State name".
Provider Business Mailing Address Postal Code900245434
The postal ZIP or zone code in the mailing address of the provider being identified. NOTE: ZIP code plus 4-digit extension, if available. This data element may contain the same information as "Provider location address postal code".
Provider Business Mailing Address Telephone Number3104783711
The telephone number associated with mailing address of the provider being identified. This data element may contain the same information as "Provider location address telephone number".
Healthcare Provider Taxonomy Code #1224Y00000X
The Health Care Provider Taxonomy code is a unique alphanumeric code, ten characters in length. The code set is structured into three distinct "Levels" including Provider Type, Classification, and Area of Specialization.
Healthcare Provider Taxonomy 1Clinical Exercise Physiologist
A Clinical Exercise Physiologist is a health care professional who is trained to work with patients with chronic disease where exercise training has been shown to be of therapeutic benefit, including but not limited to cardiovascular and pulmonary disease, and metabolic disorders.
Healthcare Provider Primary Taxonomy Switch 1Y
Primary Taxonomy:
  • X - The primary taxonomy switch is Not Answered;
  • Y - The taxonomy is the primary taxonomy (there can be only one per NPI record);
  • N - The taxonomy is not the primary taxonomy.
Provider Gender CodeM
  • M - male
  • F - female
Is sole proprietorN
  • X - Not Answered
  • Y - Yes, Entity Type 1 Provider (Individual) is a Sole Proprietor
  • N - No, Entity Type 1 Provider (Individual) is not a Sole Proprietor
X

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