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1013973296 NPI number — WHITE RIVER ANESTHESIA ASSOCIATES, INC

NPI Number: 1013973296
Health Care Provider/Practitioner: WHITE RIVER ANESTHESIA ASSOCIATES, INC

Information about “1013973296” NPI (WHITE RIVER ANESTHESIA ASSOCIATES, INC) exists in 1013973296 in HTML format HTML  |  1013973296 in plain Text format TXT  |  1013973296 in PDF (Portable Document Format) PDF  |  1013973296 in an XML format XML  formats.

NPI Number : 1013973296 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1013973296",
    "EntityType": "Organization",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": null,
    "IsOrgSubpart": "N",
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": "WHITE RIVER ANESTHESIA ASSOCIATES, INC",
    "LastName": null,
    "FirstName": null,
    "MiddleName": null,
    "NamePrefix": null,
    "NameSuffix": null,
    "Credential": null,
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": null,
    "OtherFirstName": null,
    "OtherMiddleName": null,
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": null,
    "FirstLineMailingAddress": "PO BOX 842120",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "KANSAS CITY",
    "MailingAddressStateName": "MO",
    "MailingAddressPostalCode": "64184-2120",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "800-277-8151",
    "MailingAddressFaxNumber": null,
    "FirstLinePracticeLocationAddress": "525 BRANSON LANDING BLVD",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "BRANSON",
    "PracticeLocationAddressStateName": "MO",
    "PracticeLocationAddressPostalCode": "65616-2052",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "417-239-3392",
    "PracticeLocationAddressFaxNumber": "417-239-3394",
    "EnumerationDate": "04/25/2006",
    "LastUpdateDate": "06/01/2016",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": null,
    "Gender": null,
    "AuthorizedOfficialLastName": "LUDER",
    "AuthorizedOfficialFirstName": "JACOB",
    "AuthorizedOfficialMiddleName": "K.",
    "AuthorizedOfficialTitle": "PRESIDENT",
    "AuthorizedOfficialNamePrefix": null,
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": "M.D.",
    "AuthorizedOfficialTelephoneNumber": "417-239-3392",
    "Taxonomies": {
      "Taxonomy": [
        {
          "TaxonomyCode": "367500000X",
          "TaxonomyName": "Certified Registered Nurse Anesthetist",
          "LicenseNumber": null,
          "LicenseNumberStateCode": null,
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "207L00000X",
          "TaxonomyName": "Anesthesiology Physician",
          "LicenseNumber": null,
          "LicenseNumberStateCode": null,
          "PrimaryTaxonomySwitch": "Y"
        }
      ]
    },
    "HealthcareProviderTaxonomyGroups": {
      "HealthcareProviderTaxonomyGroup": [
        {
          "HealthcareProviderTaxonomyGroupName": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
          "HealthcareProviderTaxonomyGroupDescription": "Single Specialty Group - A business group of one or more individual practitioners, all of who practice with the same area of specialization."
        },
        {
          "HealthcareProviderTaxonomyGroupName": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
          "HealthcareProviderTaxonomyGroupDescription": "Single Specialty Group - A business group of one or more individual practitioners, all of who practice with the same area of specialization."
        }
      ]
    }
  }
}
                
            

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