NPI Code Detail JSON Logo

1053003665 NPI number — MATTHEW JAMES HORROCKS

NPI Number: 1053003665
Health Care Provider/Practitioner: MATTHEW JAMES HORROCKS

Information about “1053003665” NPI (MATTHEW JAMES HORROCKS) exists in 1053003665 in HTML format HTML  |  1053003665 in plain Text format TXT  |  1053003665 in PDF (Portable Document Format) PDF  |  1053003665 in an XML format XML  formats.

NPI Number : 1053003665 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1053003665",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "N",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "HORROCKS",
    "FirstName": "MATTHEW",
    "MiddleName": "JAMES",
    "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 608",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "MALONE",
    "MailingAddressStateName": "NY",
    "MailingAddressPostalCode": "12953-0608",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "518-483-1251",
    "MailingAddressFaxNumber": null,
    "FirstLinePracticeLocationAddress": "650 STATE STREET",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "WATERTOWN",
    "PracticeLocationAddressStateName": "NY",
    "PracticeLocationAddressPostalCode": "13601-2839",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "315-755-1251",
    "PracticeLocationAddressFaxNumber": "315-291-6601",
    "EnumerationDate": "05/23/2023",
    "LastUpdateDate": "06/04/2024",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": "M",
    "Gender": "Male",
    "AuthorizedOfficialLastName": null,
    "AuthorizedOfficialFirstName": null,
    "AuthorizedOfficialMiddleName": null,
    "AuthorizedOfficialTitle": null,
    "AuthorizedOfficialNamePrefix": null,
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": null,
    "AuthorizedOfficialTelephoneNumber": null,
    "Taxonomies": {
      "Taxonomy": [
        {
          "TaxonomyCode": "1041C0700X",
          "TaxonomyName": "Clinical Social Worker",
          "LicenseNumber": null,
          "LicenseNumberStateCode": null,
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "104100000X",
          "TaxonomyName": "Social Worker",
          "LicenseNumber": null,
          "LicenseNumberStateCode": null,
          "PrimaryTaxonomySwitch": "Y"
        }
      ]
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

Copyright © 2007-2026 Data Labs Health. All rights reserved.