1093050957 NPI number — KENNETH A. FOLSOM HAS, BC-HIS, ACA

NPI Number: 1093050957
Health Care Provider/Practitioner: KENNETH A. FOLSOM HAS, BC-HIS, ACA

NPI Number : 1093050957 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1093050957",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "N",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "FOLSOM",
    "FirstName": "KENNETH",
    "MiddleName": "A.",
    "NamePrefix": "MR.",
    "NameSuffix": null,
    "Credential": "HAS, BC-HIS, ACA",
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": null,
    "OtherFirstName": null,
    "OtherMiddleName": null,
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": null,
    "FirstLineMailingAddress": "903 N. MONROE ST.",
    "SecondLineMailingAddress": "#3",
    "MailingAddressCityName": "TALLAHASSEE",
    "MailingAddressStateName": "FL",
    "MailingAddressPostalCode": "32303",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "850-898-5633",
    "MailingAddressFaxNumber": "850-898-4994",
    "FirstLinePracticeLocationAddress": "903 N MONROE ST",
    "SecondLinePracticeLocationAddress": "#3",
    "PracticeLocationAddressCityName": "TALLAHASSEE",
    "PracticeLocationAddressStateName": "FL",
    "PracticeLocationAddressPostalCode": "32303",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "850-878-5633",
    "PracticeLocationAddressFaxNumber": "850-878-4994",
    "EnumerationDate": "12/04/2012",
    "LastUpdateDate": "12/04/2012",
    "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": "237700000X",
        "TaxonomyName": "Hearing Instrument Specialist",
        "LicenseNumber": "AS972",
        "LicenseNumberStateCode": "FL",
        "PrimaryTaxonomySwitch": "Y"
      }
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}