Active NPI
Khin Aye Htwe, CFA
- Surgical Assistant
- Bloomington, IL
National Provider Identifier
1205017266
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Surgical Assistant
- 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
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
| License | State | Type | Specialty |
|---|---|---|---|
| 238000156 | IL | MD | Surgical 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.