Individual provider Active NPI

Khin Aye Htwe, CFA

  • Surgical Assistant
  • Bloomington, IL
National Provider Identifier
1205017266
Registry record updated Nov 19, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical AssistantTaxonomy code 246ZC0007X
Practice address
3002 Gill St
Bloomington, IL 61704-3438
Phone
(847) 204-6943
NPI assigned
Nov 19, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 19, 2007

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Assistant 246ZC0007X IL Primary

Addresses

Primary practice location

3002 Gill St
Bloomington, IL 61704-3438

Mailing address

1214 Brentwood CT
Normal, IL 61761-1809
Phone (847) 204-6943

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
238000156ILMDSurgical Assistant

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1195430400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1195430400000",
    "number": "1205017266",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1214 BRENTWOOD CT",
            "city": "NORMAL",
            "state": "IL",
            "postal_code": "617611809",
            "telephone_number": "847-204-6943"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3002 GILL ST",
            "city": "BLOOMINGTON",
            "state": "IL",
            "postal_code": "617043438",
            "telephone_number": "847-204-6943"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HTWE",
        "first_name": "KHIN",
        "middle_name": "AYE",
        "credential": "CFA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-11-19",
        "last_updated": "2007-11-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "246ZC0007X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Other, Surgical Assistant",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bloomington, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 19, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.