{
"Npi": {
"NPI": "1033466784",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "KEADY FAMILY PRACTICE, LLC",
"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": "214 WASHINGTON ST",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "CLAREMONT",
"MailingAddressStateName": "NH",
"MailingAddressPostalCode": "03743-5512",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "603-863-7777",
"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "214 WASHINGTON ST",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "CLAREMONT",
"PracticeLocationAddressStateName": "NH",
"PracticeLocationAddressPostalCode": "03743-5512",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "603-863-7777",
"PracticeLocationAddressFaxNumber": "603-769-3406",
"EnumerationDate": "08/13/2012",
"LastUpdateDate": "01/27/2025",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "KEADY",
"AuthorizedOfficialFirstName": "JAMES",
"AuthorizedOfficialMiddleName": "PATRICK",
"AuthorizedOfficialTitle": "PRACTICE MANAGER",
"AuthorizedOfficialNamePrefix": "MR.",
"AuthorizedOfficialNameSuffix": "JR.",
"AuthorizedOfficialCredential": null,
"AuthorizedOfficialTelephoneNumber": "603-826-3434",
"Taxonomies": {
"Taxonomy": [
{
"TaxonomyCode": "332900000X",
"TaxonomyName": "Non-Pharmacy Dispensing Site",
"LicenseNumber": null,
"LicenseNumberStateCode": null,
"PrimaryTaxonomySwitch": "N"
},
{
"TaxonomyCode": "364SF0001X",
"TaxonomyName": "Family Health Clinical Nurse Specialist",
"LicenseNumber": "052532-23",
"LicenseNumberStateCode": "NH",
"PrimaryTaxonomySwitch": "Y"
}
]
},
"HealthcareProviderTaxonomyGroups": {
"HealthcareProviderTaxonomyGroup": {
"HealthcareProviderTaxonomyGroupName": "193400000X 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."
}
}
}
}