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1053185561 NPI number — LAKSHMI SRUTHI DATLA

NPI Number: 1053185561
Health Care Provider/Practitioner: LAKSHMI SRUTHI DATLA

Information about “1053185561” NPI (LAKSHMI SRUTHI DATLA) exists in 1053185561 in HTML format HTML  |  1053185561 in plain Text format TXT  |  1053185561 in PDF (Portable Document Format) PDF  |  1053185561 in an XML format XML  formats.

NPI Number : 1053185561 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1053185561",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "Y",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "DATLA",
    "FirstName": "LAKSHMI",
    "MiddleName": "SRUTHI",
    "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": "11 N TOMPKINS SQ",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "DOWNINGTOWN",
    "MailingAddressStateName": "PA",
    "MailingAddressPostalCode": "19335-3173",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "234-567-1456",
    "MailingAddressFaxNumber": null,
    "FirstLinePracticeLocationAddress": "11 N TOMPKINS SQ",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "DOWNINGTOWN",
    "PracticeLocationAddressStateName": "PA",
    "PracticeLocationAddressPostalCode": "19335-3173",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "234-567-1456",
    "PracticeLocationAddressFaxNumber": null,
    "EnumerationDate": "11/14/2023",
    "LastUpdateDate": "11/14/2023",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": "F",
    "Gender": "Female",
    "AuthorizedOfficialLastName": null,
    "AuthorizedOfficialFirstName": null,
    "AuthorizedOfficialMiddleName": null,
    "AuthorizedOfficialTitle": null,
    "AuthorizedOfficialNamePrefix": null,
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": null,
    "AuthorizedOfficialTelephoneNumber": null,
    "Taxonomies": {
      "Taxonomy": [
        {
          "TaxonomyCode": "225200000X",
          "TaxonomyName": "Physical Therapy Assistant",
          "LicenseNumber": null,
          "LicenseNumberStateCode": null,
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "225X00000X",
          "TaxonomyName": "Occupational Therapist",
          "LicenseNumber": null,
          "LicenseNumberStateCode": null,
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "235Z00000X",
          "TaxonomyName": "Speech-Language Pathologist",
          "LicenseNumber": null,
          "LicenseNumberStateCode": null,
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "225100000X",
          "TaxonomyName": "Physical Therapist",
          "LicenseNumber": null,
          "LicenseNumberStateCode": null,
          "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."
      }
    }
  }
}
                
            

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