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index.html
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index.html
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<!DOCTYPE html>
<head>
<meta charset="utf-8">
<title>Medical Provider Search</title>
<link rel="stylesheet" href="css/normalize.min.css">
<link rel="stylesheet" href="css/main.css">
<script src="js/vendor/modernizr-2.6.2-respond-1.1.0.min.js"></script>
</head>
<body onload="$('#tabState').hide();">
<div class="header-container">
<header class="wrapper clearfix">
<h1 class="title">Medical Provider Search</h1>
</header>
</div>
<div class="main-container">
<div class="main wrapper clearfix">
<div class="form-item-first">
<label class="control-label highlight">Demo Version: </label>
<span class="highlight">Partial NY state only</span>
</div>
<form id="myForm">
<div class="form-item-first">
<label for="npi" class="control-label" >NPI Number :</label>
<input type="text" id="npi" name="npi" class="control" maxlength="10"/>
<span class="error-msg" id="npi-error"></span>
</div>
<div class="form-item bigOR">
OR
</div>
<div class="form-item">
<label for="name" class="control-label">Name :</label>
<input type="text" id="name" name="name" class="control"/><br />
<label class="control-label"> </label>
<span class="underText">Last, First or Organization name</span>
</div>
<div class="form-item">
<label class="control-label">Type :</label>
<input type="radio" name="type" value="1" checked="checked" />
<label class="radio-label">Individual</label>
<input type="radio" name="type" value="2" />
<label class="radio-label">Organization</label>
</div>
<div class="form-item">
<label class="control-label">Location(s) :</label>
<input type="checkbox" disabled="disabled" name="state" value="**" /> <label class="checkbox-label">All States</label>
<input id="show_states" class="btn-link" type="button" value="Show States">
</div>
<div class="form-item">
<label class="control-label"> </label>
<table class="state" id="tabState">
<tr>
<td><input type="checkbox" name="state" disabled="disabled" value="AK"/> <label class="checkbox-label">AK</label></td>
<td><input type="checkbox" name="state" disabled="disabled" value="AL"/> <label class="checkbox-label">AL</label></td>
<td><input type="checkbox" name="state" disabled="disabled" value="AR"/> <label class="checkbox-label">AR</label></td>
<td><input type="checkbox" name="state" disabled="disabled" value="AZ"/> <label class="checkbox-label">AZ</label></td>
<td><input type="checkbox" name="state" disabled="disabled" value="CA"/> <label class="checkbox-label">CA</label></td>
</tr>
<tr>
<td><input type="checkbox" name="state" disabled="disabled" value="CO"/> <label class="checkbox-label">CO</label></td>
<td><input type="checkbox" name="state" disabled="disabled" value="CT"/> <label class="checkbox-label">CT</label></td>
<td><input type="checkbox" name="state" disabled="disabled" value="DC"/> <label class="checkbox-label">DC</label></td>
<td><input type="checkbox" name="state" disabled="disabled" value="DE"/> <label class="checkbox-label">DE</label></td>
<td><input type="checkbox" name="state" disabled="disabled" value="FL"/> <label class="checkbox-label">FL</label></td>
</tr>
<tr>
<td><input type="checkbox" name="state" disabled="disabled" value="GA"/> <label class="checkbox-label">GA</label></td>
<td><input type="checkbox" name="state" disabled="disabled" value="HI"/> <label class="checkbox-label">HI</label></td>
<td><input type="checkbox" name="state" disabled="disabled" value="IA"/> <label class="checkbox-label">IA</label></td>
<td><input type="checkbox" name="state" disabled="disabled" value="ID"/> <label class="checkbox-label">ID</label></td>
<td><input type="checkbox" name="state" disabled="disabled" value="IL"/> <label class="checkbox-label">IL</label></td>
</tr>
<tr>
<td><input type="checkbox" name="state" disabled="disabled" value="IN"/> <label class="checkbox-label">IN</label></td>
<td><input type="checkbox" name="state" disabled="disabled" value="KS"/> <label class="checkbox-label">KS</label></td>
<td><input type="checkbox" name="state" disabled="disabled" value="KY"/> <label class="checkbox-label">KY</label></td>
<td><input type="checkbox" name="state" disabled="disabled" value="LA"/> <label class="checkbox-label">LA</label></td>
<td><input type="checkbox" name="state" disabled="disabled" value="MA"/> <label class="checkbox-label">MA</label></td>
</tr>
<tr>
<td><input type="checkbox" name="state" disabled="disabled" value="MD"/> <label class="checkbox-label">MD</label></td>
<td><input type="checkbox" name="state" disabled="disabled" value="ME"/> <label class="checkbox-label">ME</label></td>
<td><input type="checkbox" name="state" disabled="disabled" value="MI"/> <label class="checkbox-label">MI</label></td>
<td><input type="checkbox" name="state" disabled="disabled" value="MN"/> <label class="checkbox-label">MN</label></td>
<td><input type="checkbox" name="state" disabled="disabled" value="MO"/> <label class="checkbox-label">MO</label></td>
</tr>
<tr>
<td><input type="checkbox" name="state" disabled="disabled" value="MS"/> <label class="checkbox-label">MS</label></td>
<td><input type="checkbox" name="state" disabled="disabled" value="MT"/> <label class="checkbox-label">MT</label></td>
<td><input type="checkbox" name="state" disabled="disabled" value="NC"/> <label class="checkbox-label">NC</label></td>
<td><input type="checkbox" name="state" disabled="disabled" value="ND"/> <label class="checkbox-label">ND</label></td>
<td><input type="checkbox" name="state" disabled="disabled" value="NE"/> <label class="checkbox-label">NE</label></td>
</tr>
<tr>
<td><input type="checkbox" name="state" disabled="disabled" value="NH"/> <label class="checkbox-label">NH</label></td>
<td><input type="checkbox" name="state" disabled="disabled" value="NJ"/> <label class="checkbox-label">NJ</label></td>
<td><input type="checkbox" name="state" disabled="disabled" value="NM"/> <label class="checkbox-label">NM</label></td>
<td><input type="checkbox" name="state" disabled="disabled" value="NV"/> <label class="checkbox-label">NV</label></td>
<td><input type="checkbox" name="state" disabled="disabled" value="NY" Checked="Checked" /> <label class="checkbox-label">NY</label></td>
</tr>
<tr>
<td><input type="checkbox" name="state" disabled="disabled" value="OH"/> <label class="checkbox-label">OH</label></td>
<td><input type="checkbox" name="state" disabled="disabled" value="OK"/> <label class="checkbox-label">OK</label></td>
<td><input type="checkbox" name="state" disabled="disabled" value="OR"/> <label class="checkbox-label">OR</label></td>
<td><input type="checkbox" name="state" disabled="disabled" value="PA"/> <label class="checkbox-label">PA</label></td>
<td><input type="checkbox" name="state" disabled="disabled" value="PR"/> <label class="checkbox-label">PR</label></td>
</tr>
<tr>
<td><input type="checkbox" name="state" disabled="disabled" value="RI"/> <label class="checkbox-label">RI</label></td>
<td><input type="checkbox" name="state" disabled="disabled" value="SC"/> <label class="checkbox-label">SC</label></td>
<td><input type="checkbox" name="state" disabled="disabled" value="SD"/> <label class="checkbox-label">SD</label></td>
<td><input type="checkbox" name="state" disabled="disabled" value="TN"/> <label class="checkbox-label">TN</label></td>
<td><input type="checkbox" name="state" disabled="disabled" value="TX"/> <label class="checkbox-label">TX</label></td>
</tr>
<tr>
<td><input type="checkbox" name="state" disabled="disabled" value="UT"/> <label class="checkbox-label">UT</label></td>
<td><input type="checkbox" name="state" disabled="disabled" value="VA"/> <label class="checkbox-label">VA</label></td>
<td><input type="checkbox" name="state" disabled="disabled" value="VT"/> <label class="checkbox-label">VT</label></td>
<td><input type="checkbox" name="state" disabled="disabled" value="WA"/> <label class="checkbox-label">WA</label></td>
<td><input type="checkbox" name="state" disabled="disabled" value="WI"/> <label class="checkbox-label">WI</label></td>
</tr>
<tr>
<td><input type="checkbox" name="state" disabled="disabled" value="WV"/> <label class="checkbox-label">WV</label></td>
<td><input type="checkbox" name="state" disabled="disabled" value="WY"/> <label class="checkbox-label">WY</label></td>
<td colspan="2" class="highlight">Demo Version: NY only</td>
<td><input id="hide_states" class="btn-link" type="button" value="Hide States"></td>
</tr>
</table>
</div>
<div id="form-buttons" class="form-action">
<input id="clear_form" class="btn-clear" type="button" value="Clear">
<input id="submit_form" class="btn-search" type="button" value="Search">
</div>
<div class="form-item" id="results"></div>
</form>
<div id="loader">
<img id="ajax-gif" src="http://coolthebeans.com/npi/images/ajax.gif" alt="Loading..."/>
</div>
</div> <!-- #main -->
</div> <!-- #main-container -->
<script src="//ajax.googleapis.com/ajax/libs/jquery/1.11.0/jquery.min.js"></script>
<script>window.jQuery || document.write('<script src="js/vendor/jquery-1.11.0.min.js"><\/script>')</script>
<script src="js/main.js"></script>
</body>
</html>