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1023463577 NPI number — ARCTIC CHIROPRACTIC AND PHYSICAL MEDICINE KETCHIKAN

NPI Number: 1023463577
Health Care Provider/Practitioner: ARCTIC CHIROPRACTIC AND PHYSICAL MEDICINE KETCHIKAN

Information about “1023463577” NPI (ARCTIC CHIROPRACTIC AND PHYSICAL MEDICINE KETCHIKAN) exists in 1023463577 in HTML format HTML  |  1023463577 in plain Text format TXT  |  1023463577 in PDF (Portable Document Format) PDF  |  1023463577 in an XML format XML  formats.

NPI Number : 1023463577 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1023463577",
    "EntityType": "Organization",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": null,
    "IsOrgSubpart": "N",
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": "ARCTIC CHIROPRACTIC AND PHYSICAL MEDICINE KETCHIKAN",
    "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": "2243 JORDAN AVE",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "JUNEAU",
    "MailingAddressStateName": "AK",
    "MailingAddressPostalCode": "99801-8050",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "907-790-3371",
    "MailingAddressFaxNumber": "907-790-2102",
    "FirstLinePracticeLocationAddress": "2050 SEA LEVEL DR",
    "SecondLinePracticeLocationAddress": "SUITE 106",
    "PracticeLocationAddressCityName": "KETCHIKAN",
    "PracticeLocationAddressStateName": "AK",
    "PracticeLocationAddressPostalCode": "99901-6058",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "907-790-3371",
    "PracticeLocationAddressFaxNumber": "907-790-2102",
    "EnumerationDate": "05/03/2016",
    "LastUpdateDate": "05/24/2016",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": null,
    "Gender": null,
    "AuthorizedOfficialLastName": "CHAVIS",
    "AuthorizedOfficialFirstName": "JAMES",
    "AuthorizedOfficialMiddleName": null,
    "AuthorizedOfficialTitle": "OWNER",
    "AuthorizedOfficialNamePrefix": null,
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": "D.C.",
    "AuthorizedOfficialTelephoneNumber": "907-888-9032",
    "Taxonomies": {
      "Taxonomy": [
        {
          "TaxonomyCode": "225100000X",
          "TaxonomyName": "Physical Therapist",
          "LicenseNumber": "104600",
          "LicenseNumberStateCode": "AK",
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "111N00000X",
          "TaxonomyName": "Chiropractor",
          "LicenseNumber": "468",
          "LicenseNumberStateCode": "AK",
          "PrimaryTaxonomySwitch": "Y"
        }
      ]
    },
    "HealthcareProviderTaxonomyGroups": {
      "HealthcareProviderTaxonomyGroup": [
        {
          "HealthcareProviderTaxonomyGroupName": "193200000X MULTI-SPECIALTY GROUP",
          "HealthcareProviderTaxonomyGroupDescription": "Multi-Specialty Group - A business group of one or more individual practitioners, who practice with different areas of specialization."
        },
        {
          "HealthcareProviderTaxonomyGroupName": "193200000X MULTI-SPECIALTY GROUP",
          "HealthcareProviderTaxonomyGroupDescription": "Multi-Specialty Group - A business group of one or more individual practitioners, who practice with different areas of specialization."
        }
      ]
    }
  }
}
                
            

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