ROY E. CULBERSON
Complete NPI Record 1811217789
Clinic/Center - Rehabilitation, Substance Use Disorder in Denton, TX

Complete NPI Dataset

This page represents the complete record for NPI 1811217789. You can access the complete dataset, including a full list of field names, along with their values, and definitions as recorded by the NPI registry. Each field in the NPI record is explained, highlighting its significance and the possible values it can hold.

NPI: 1811217789

The 10-position all-numeric identification number assigned by the NPS to uniquely identify a health care provider. The NPI number includes an ISO standard check-digit in the 10th position. There is no intelligence about the health care provider in the number.

Entity Type Code: 2

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).

Employer Identification Number EIN: UNAVAIL

The Employer Identification Number (EIN), assigned by the IRS, of the provider being identified.

Provider Organization Name Legal Business Name: FIRST STEP DENTON COUNTY OUTREACH PROGRAM

The name of the organization provider. If the provider is an organization, this is the legal business name.

Provider Other Organization Name: ROY E. CULBERSON

Other name by which the organization provider is or has been known.

Provider Other Organization Name Type Code: 5

Code identifying the type of other name. Codes are: 1 = former name; 2 = professional name; 3 = doing business as (d/b/ a) name; 4 = former legal business name; 5 = other.

Provider First Line Business Mailing Address: 1310 TEASLEY LN

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 Name: DENTON

The city name in the mailing address of the provider being identified.

Provider Business Mailing Address State Name: TX

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 Code: 762057946

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 Country Code If outside U S : US

The country code in the mailing address of the provider being identified. This data element may contain the same information as "Provider location address country code".

Provider Business Mailing Address Telephone Number: 9404847837

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".

Provider Business Mailing Address Fax Number: 9404847835

The fax number associated with the mailing address of the provider being identified. This data element may contain the same information as "Provider location address fax number".

Provider First Line Business Practice Location Address: 1310 TEASLEY LN

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 Name: DENTON

The city name in the location address of the provider being identified.

Provider Business Practice Location Address State Name: TX

The State code in the location of the provider being identified.

Provider Business Practice Location Address Postal Code: 762057946

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 Country Code If outside U S : US

The country code in the location address of the provider being identified.

Provider Business Practice Location Address Telephone Number: 9404847837

The telephone number associated with the location address of the provider being identified.

Provider Business Practice Location Address Fax Number: 9404847835

The fax number associated with the location address of the provider being identified.

Provider Enumeration Date: 6/2/2010

The date the provider was assigned a unique identifier (assigned an NPI).

Last Update Date: 6/2/2010

The date that a record was last updated or changed.

Authorized Official Last Name: CULBERSON

The last name of the person authorized to submit the NPI application or to change NPS data for a health care provider.

Authorized Official First Name: ROY

The first name of the authorized official.

Authorized Official Middle Name: EDWARD

The middle name of the authorized official.

Authorized Official Title or Position: EXECUTIVE DIRECTOR

The title or position of the authorized official.

Authorized Official Telephone Number: 9404847837

The 10-position telephone number of the authorized official.

Healthcare Provider Taxonomy Code 1: 251C00000X

This field represents the provider's taxonomy code, which classifies their type, classification, and area of specialization. This code comes from the Healthcare Provider Taxonomy Code Set maintained by the National Uniform Claim Committee (NUCC). The NPS will associate these data with the license data for providers with Entity type code = 1.

Provider License Number 1: 3160-3161

The license number issued to the provider being identified. The NPS can accommodate multiple license numbers for multiple specialties and for multiple States. The NPS will associate this data element with "provider taxonomy code".

Provider License Number State Code 1: TX

The two-letter state code representing the U.S. state or territory that issued the provider's license. This field is linked to the Provider License Number field and identifies the jurisdiction where that license is valid. A provider may have multiple state codes if they hold licenses in more than one state.

Healthcare Provider Primary Taxonomy Switch 1: N

This field shows whether the related taxonomy code is the provider's primary specialty. It is a single-character value: "Y" indicates the taxonomy is the primary one, while "N" indicates it is not. Each provider record can have only one taxonomy code marked as primary.

Healthcare Provider Taxonomy Code 2: 251E00000X

This field represents the provider's taxonomy code, which classifies their type, classification, and area of specialization. This code comes from the Healthcare Provider Taxonomy Code Set maintained by the National Uniform Claim Committee (NUCC). The NPS will associate these data with the license data for providers with Entity type code = 1.

Provider License Number 2: 3160-3161

The license number issued to the provider being identified. The NPS can accommodate multiple license numbers for multiple specialties and for multiple States. The NPS will associate this data element with "provider taxonomy code".

Provider License Number State Code 2: TX

The two-letter state code representing the U.S. state or territory that issued the provider's license. This field is linked to the Provider License Number field and identifies the jurisdiction where that license is valid. A provider may have multiple state codes if they hold licenses in more than one state.

Healthcare Provider Primary Taxonomy Switch 2: N

This field shows whether the related taxonomy code is the provider's primary specialty. It is a single-character value: "Y" indicates the taxonomy is the primary one, while "N" indicates it is not. Each provider record can have only one taxonomy code marked as primary.

Healthcare Provider Taxonomy Code 3: 251S00000X

This field represents the provider's taxonomy code, which classifies their type, classification, and area of specialization. This code comes from the Healthcare Provider Taxonomy Code Set maintained by the National Uniform Claim Committee (NUCC). The NPS will associate these data with the license data for providers with Entity type code = 1.

Provider License Number 3: 3160-3161

The license number issued to the provider being identified. The NPS can accommodate multiple license numbers for multiple specialties and for multiple States. The NPS will associate this data element with "provider taxonomy code".

Provider License Number State Code 3: TX

The two-letter state code representing the U.S. state or territory that issued the provider's license. This field is linked to the Provider License Number field and identifies the jurisdiction where that license is valid. A provider may have multiple state codes if they hold licenses in more than one state.

Healthcare Provider Primary Taxonomy Switch 3: N

This field shows whether the related taxonomy code is the provider's primary specialty. It is a single-character value: "Y" indicates the taxonomy is the primary one, while "N" indicates it is not. Each provider record can have only one taxonomy code marked as primary.

Healthcare Provider Taxonomy Code 4: 101YA0400X

This field represents the provider's taxonomy code, which classifies their type, classification, and area of specialization. This code comes from the Healthcare Provider Taxonomy Code Set maintained by the National Uniform Claim Committee (NUCC). The NPS will associate these data with the license data for providers with Entity type code = 1.

Provider License Number 4: 3160-3161

The license number issued to the provider being identified. The NPS can accommodate multiple license numbers for multiple specialties and for multiple States. The NPS will associate this data element with "provider taxonomy code".

Provider License Number State Code 4: TX

The two-letter state code representing the U.S. state or territory that issued the provider's license. This field is linked to the Provider License Number field and identifies the jurisdiction where that license is valid. A provider may have multiple state codes if they hold licenses in more than one state.

Healthcare Provider Primary Taxonomy Switch 4: N

This field shows whether the related taxonomy code is the provider's primary specialty. It is a single-character value: "Y" indicates the taxonomy is the primary one, while "N" indicates it is not. Each provider record can have only one taxonomy code marked as primary.

Healthcare Provider Taxonomy Code 5: 101YP2500X

This field represents the provider's taxonomy code, which classifies their type, classification, and area of specialization. This code comes from the Healthcare Provider Taxonomy Code Set maintained by the National Uniform Claim Committee (NUCC). The NPS will associate these data with the license data for providers with Entity type code = 1.

Provider License Number 5: 3160-3161

The license number issued to the provider being identified. The NPS can accommodate multiple license numbers for multiple specialties and for multiple States. The NPS will associate this data element with "provider taxonomy code".

Provider License Number State Code 5: TX

The two-letter state code representing the U.S. state or territory that issued the provider's license. This field is linked to the Provider License Number field and identifies the jurisdiction where that license is valid. A provider may have multiple state codes if they hold licenses in more than one state.

Healthcare Provider Primary Taxonomy Switch 5: N

This field shows whether the related taxonomy code is the provider's primary specialty. It is a single-character value: "Y" indicates the taxonomy is the primary one, while "N" indicates it is not. Each provider record can have only one taxonomy code marked as primary.

Healthcare Provider Taxonomy Code 6: 103TA0400X

This field represents the provider's taxonomy code, which classifies their type, classification, and area of specialization. This code comes from the Healthcare Provider Taxonomy Code Set maintained by the National Uniform Claim Committee (NUCC). The NPS will associate these data with the license data for providers with Entity type code = 1.

Provider License Number 6: 3160-3161

The license number issued to the provider being identified. The NPS can accommodate multiple license numbers for multiple specialties and for multiple States. The NPS will associate this data element with "provider taxonomy code".

Provider License Number State Code 6: TX

The two-letter state code representing the U.S. state or territory that issued the provider's license. This field is linked to the Provider License Number field and identifies the jurisdiction where that license is valid. A provider may have multiple state codes if they hold licenses in more than one state.

Healthcare Provider Primary Taxonomy Switch 6: N

This field shows whether the related taxonomy code is the provider's primary specialty. It is a single-character value: "Y" indicates the taxonomy is the primary one, while "N" indicates it is not. Each provider record can have only one taxonomy code marked as primary.

Healthcare Provider Taxonomy Code 7: 103TB0200X

This field represents the provider's taxonomy code, which classifies their type, classification, and area of specialization. This code comes from the Healthcare Provider Taxonomy Code Set maintained by the National Uniform Claim Committee (NUCC). The NPS will associate these data with the license data for providers with Entity type code = 1.

Provider License Number 7: 3160-3161

The license number issued to the provider being identified. The NPS can accommodate multiple license numbers for multiple specialties and for multiple States. The NPS will associate this data element with "provider taxonomy code".

Provider License Number State Code 7: TX

The two-letter state code representing the U.S. state or territory that issued the provider's license. This field is linked to the Provider License Number field and identifies the jurisdiction where that license is valid. A provider may have multiple state codes if they hold licenses in more than one state.

Healthcare Provider Primary Taxonomy Switch 7: N

This field shows whether the related taxonomy code is the provider's primary specialty. It is a single-character value: "Y" indicates the taxonomy is the primary one, while "N" indicates it is not. Each provider record can have only one taxonomy code marked as primary.

Healthcare Provider Taxonomy Code 8: 103TC0700X

This field represents the provider's taxonomy code, which classifies their type, classification, and area of specialization. This code comes from the Healthcare Provider Taxonomy Code Set maintained by the National Uniform Claim Committee (NUCC). The NPS will associate these data with the license data for providers with Entity type code = 1.

Provider License Number 8: 3160-3161

The license number issued to the provider being identified. The NPS can accommodate multiple license numbers for multiple specialties and for multiple States. The NPS will associate this data element with "provider taxonomy code".

Provider License Number State Code 8: TX

The two-letter state code representing the U.S. state or territory that issued the provider's license. This field is linked to the Provider License Number field and identifies the jurisdiction where that license is valid. A provider may have multiple state codes if they hold licenses in more than one state.

Healthcare Provider Primary Taxonomy Switch 8: N

This field shows whether the related taxonomy code is the provider's primary specialty. It is a single-character value: "Y" indicates the taxonomy is the primary one, while "N" indicates it is not. Each provider record can have only one taxonomy code marked as primary.

Healthcare Provider Taxonomy Code 9: 103TC1900X

This field represents the provider's taxonomy code, which classifies their type, classification, and area of specialization. This code comes from the Healthcare Provider Taxonomy Code Set maintained by the National Uniform Claim Committee (NUCC). The NPS will associate these data with the license data for providers with Entity type code = 1.

Provider License Number 9: 3160-3161

The license number issued to the provider being identified. The NPS can accommodate multiple license numbers for multiple specialties and for multiple States. The NPS will associate this data element with "provider taxonomy code".

Provider License Number State Code 9: TX

The two-letter state code representing the U.S. state or territory that issued the provider's license. This field is linked to the Provider License Number field and identifies the jurisdiction where that license is valid. A provider may have multiple state codes if they hold licenses in more than one state.

Healthcare Provider Primary Taxonomy Switch 9: N

This field shows whether the related taxonomy code is the provider's primary specialty. It is a single-character value: "Y" indicates the taxonomy is the primary one, while "N" indicates it is not. Each provider record can have only one taxonomy code marked as primary.

Healthcare Provider Taxonomy Code 10: 103TP2701X

This field represents the provider's taxonomy code, which classifies their type, classification, and area of specialization. This code comes from the Healthcare Provider Taxonomy Code Set maintained by the National Uniform Claim Committee (NUCC). The NPS will associate these data with the license data for providers with Entity type code = 1.

Provider License Number 10: 3160-3161

The license number issued to the provider being identified. The NPS can accommodate multiple license numbers for multiple specialties and for multiple States. The NPS will associate this data element with "provider taxonomy code".

Provider License Number State Code 10: TX

The two-letter state code representing the U.S. state or territory that issued the provider's license. This field is linked to the Provider License Number field and identifies the jurisdiction where that license is valid. A provider may have multiple state codes if they hold licenses in more than one state.

Healthcare Provider Primary Taxonomy Switch 10: N

This field shows whether the related taxonomy code is the provider's primary specialty. It is a single-character value: "Y" indicates the taxonomy is the primary one, while "N" indicates it is not. Each provider record can have only one taxonomy code marked as primary.

Healthcare Provider Taxonomy Code 11: 103TR0400X

This field represents the provider's taxonomy code, which classifies their type, classification, and area of specialization. This code comes from the Healthcare Provider Taxonomy Code Set maintained by the National Uniform Claim Committee (NUCC). The NPS will associate these data with the license data for providers with Entity type code = 1.

Provider License Number 11: 3160-3161

The license number issued to the provider being identified. The NPS can accommodate multiple license numbers for multiple specialties and for multiple States. The NPS will associate this data element with "provider taxonomy code".

Provider License Number State Code 11: TX

The two-letter state code representing the U.S. state or territory that issued the provider's license. This field is linked to the Provider License Number field and identifies the jurisdiction where that license is valid. A provider may have multiple state codes if they hold licenses in more than one state.

Healthcare Provider Primary Taxonomy Switch 11: N

This field shows whether the related taxonomy code is the provider's primary specialty. It is a single-character value: "Y" indicates the taxonomy is the primary one, while "N" indicates it is not. Each provider record can have only one taxonomy code marked as primary.

Healthcare Provider Taxonomy Code 12: 171100000X

This field represents the provider's taxonomy code, which classifies their type, classification, and area of specialization. This code comes from the Healthcare Provider Taxonomy Code Set maintained by the National Uniform Claim Committee (NUCC). The NPS will associate these data with the license data for providers with Entity type code = 1.

Provider License Number 12: 3160-3161

The license number issued to the provider being identified. The NPS can accommodate multiple license numbers for multiple specialties and for multiple States. The NPS will associate this data element with "provider taxonomy code".

Provider License Number State Code 12: TX

The two-letter state code representing the U.S. state or territory that issued the provider's license. This field is linked to the Provider License Number field and identifies the jurisdiction where that license is valid. A provider may have multiple state codes if they hold licenses in more than one state.

Healthcare Provider Primary Taxonomy Switch 12: N

This field shows whether the related taxonomy code is the provider's primary specialty. It is a single-character value: "Y" indicates the taxonomy is the primary one, while "N" indicates it is not. Each provider record can have only one taxonomy code marked as primary.

Healthcare Provider Taxonomy Code 13: 251300000X

This field represents the provider's taxonomy code, which classifies their type, classification, and area of specialization. This code comes from the Healthcare Provider Taxonomy Code Set maintained by the National Uniform Claim Committee (NUCC). The NPS will associate these data with the license data for providers with Entity type code = 1.

Healthcare Provider Primary Taxonomy Switch 13: N

This field shows whether the related taxonomy code is the provider's primary specialty. It is a single-character value: "Y" indicates the taxonomy is the primary one, while "N" indicates it is not. Each provider record can have only one taxonomy code marked as primary.

Healthcare Provider Taxonomy Code 14: 261QR0405X

This field represents the provider's taxonomy code, which classifies their type, classification, and area of specialization. This code comes from the Healthcare Provider Taxonomy Code Set maintained by the National Uniform Claim Committee (NUCC). The NPS will associate these data with the license data for providers with Entity type code = 1.

Provider License Number 14: 3160-3161

The license number issued to the provider being identified. The NPS can accommodate multiple license numbers for multiple specialties and for multiple States. The NPS will associate this data element with "provider taxonomy code".

Provider License Number State Code 14: TX

The two-letter state code representing the U.S. state or territory that issued the provider's license. This field is linked to the Provider License Number field and identifies the jurisdiction where that license is valid. A provider may have multiple state codes if they hold licenses in more than one state.

Healthcare Provider Primary Taxonomy Switch 14: Y

This field shows whether the related taxonomy code is the provider's primary specialty. It is a single-character value: "Y" indicates the taxonomy is the primary one, while "N" indicates it is not. Each provider record can have only one taxonomy code marked as primary.

Is Organization Subpart: N

Indicates whether the provider is a subpart of a larger organization. This is a single-character code: "Y" means the entity is an organizational subpart, while "N" means it is not. Subparts typically include hospital departments, clinics, or other distinct units that fall under a parent organization.

Authorized Official Name Prefix Text: MR.

The prefix used in the name of the authorized official associated with the provider's NPI record. Examples include Mr., Ms., Mrs., Dr., or other common professional or personal prefixes.

Healthcare Provider Taxonomy Group 4: 193200000X MULTI-SPECIALTY GROUP

Specifies whether the provider is part of a single-specialty or multi-specialty business group. The possible values are: 193200000X – Multi-Specialty Group or 193400000X – Single Specialty Group. This field helps distinguish the organizational structure of a provider group.

Healthcare Provider Taxonomy Group 5: 193200000X MULTI-SPECIALTY GROUP

Specifies whether the provider is part of a single-specialty or multi-specialty business group. The possible values are: 193200000X – Multi-Specialty Group or 193400000X – Single Specialty Group. This field helps distinguish the organizational structure of a provider group.

Healthcare Provider Taxonomy Group 6: 193200000X MULTI-SPECIALTY GROUP

Specifies whether the provider is part of a single-specialty or multi-specialty business group. The possible values are: 193200000X – Multi-Specialty Group or 193400000X – Single Specialty Group. This field helps distinguish the organizational structure of a provider group.

Healthcare Provider Taxonomy Group 7: 193200000X MULTI-SPECIALTY GROUP

Specifies whether the provider is part of a single-specialty or multi-specialty business group. The possible values are: 193200000X – Multi-Specialty Group or 193400000X – Single Specialty Group. This field helps distinguish the organizational structure of a provider group.

Healthcare Provider Taxonomy Group 8: 193200000X MULTI-SPECIALTY GROUP

Specifies whether the provider is part of a single-specialty or multi-specialty business group. The possible values are: 193200000X – Multi-Specialty Group or 193400000X – Single Specialty Group. This field helps distinguish the organizational structure of a provider group.

Healthcare Provider Taxonomy Group 9: 193200000X MULTI-SPECIALTY GROUP

Specifies whether the provider is part of a single-specialty or multi-specialty business group. The possible values are: 193200000X – Multi-Specialty Group or 193400000X – Single Specialty Group. This field helps distinguish the organizational structure of a provider group.

Healthcare Provider Taxonomy Group 10: 193200000X MULTI-SPECIALTY GROUP

Specifies whether the provider is part of a single-specialty or multi-specialty business group. The possible values are: 193200000X – Multi-Specialty Group or 193400000X – Single Specialty Group. This field helps distinguish the organizational structure of a provider group.

Healthcare Provider Taxonomy Group 11: 193200000X MULTI-SPECIALTY GROUP

Specifies whether the provider is part of a single-specialty or multi-specialty business group. The possible values are: 193200000X – Multi-Specialty Group or 193400000X – Single Specialty Group. This field helps distinguish the organizational structure of a provider group.

Healthcare Provider Taxonomy Group 12: 193200000X MULTI-SPECIALTY GROUP

Specifies whether the provider is part of a single-specialty or multi-specialty business group. The possible values are: 193200000X – Multi-Specialty Group or 193400000X – Single Specialty Group. This field helps distinguish the organizational structure of a provider group.