{
"Npi": {
"NPI": "1073713434",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "DEBOARD & GOVETT, DOCTORS OF CHIROPRACTIC, A PROFESSIONAL CORPORATION.",
"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": "2943 4TH ST.",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "CERES",
"MailingAddressStateName": "CA",
"MailingAddressPostalCode": "95307",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "209-537-5068",
"MailingAddressFaxNumber": "209-537-9087",
"FirstLinePracticeLocationAddress": "2943 4TH ST",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "CERES",
"PracticeLocationAddressStateName": "CA",
"PracticeLocationAddressPostalCode": "95307-3222",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "209-537-5068",
"PracticeLocationAddressFaxNumber": "209-537-9187",
"EnumerationDate": "07/23/2007",
"LastUpdateDate": "07/23/2007",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "GOVETT",
"AuthorizedOfficialFirstName": "RAYMOND",
"AuthorizedOfficialMiddleName": "ALLAN",
"AuthorizedOfficialTitle": "SECRETARY",
"AuthorizedOfficialNamePrefix": "DR.",
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "DC",
"AuthorizedOfficialTelephoneNumber": "209-537-5068",
"Taxonomies": {
"Taxonomy": [
{
"TaxonomyCode": "111N00000X",
"TaxonomyName": "Chiropractor",
"LicenseNumber": "DC0107740",
"LicenseNumberStateCode": "CA",
"PrimaryTaxonomySwitch": "N"
},
{
"TaxonomyCode": "111NI0013X",
"TaxonomyName": "Independent Medical Examiner Chiropractor",
"LicenseNumber": "DC0107830",
"LicenseNumberStateCode": "CA",
"PrimaryTaxonomySwitch": "N"
},
{
"TaxonomyCode": "111NX0800X",
"TaxonomyName": "Orthopedic Chiropractor",
"LicenseNumber": "DC0107830",
"LicenseNumberStateCode": "CA",
"PrimaryTaxonomySwitch": "N"
},
{
"TaxonomyCode": "111N00000X",
"TaxonomyName": "Chiropractor",
"LicenseNumber": "DC0107830",
"LicenseNumberStateCode": "CA",
"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."
},
{
"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."
}
]
}
}
}