{
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"OrgName": "JARED BERRYMAN CHIROPRACTIC, PLLC",
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"FirstLineMailingAddress": "47479 US HIGHWAY 41",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "HOUGHTON",
"MailingAddressStateName": "MI",
"MailingAddressPostalCode": "49931-9016",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": null,
"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "47964 MADELEINE ST",
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"PracticeLocationAddressCityName": "HOUGHTON",
"PracticeLocationAddressStateName": "MI",
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"PracticeLocationAddressTelephoneNumber": "906-523-5610",
"PracticeLocationAddressFaxNumber": null,
"EnumerationDate": "03/14/2018",
"LastUpdateDate": "03/14/2018",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "BERRYMAN",
"AuthorizedOfficialFirstName": "JARED",
"AuthorizedOfficialMiddleName": null,
"AuthorizedOfficialTitle": "OWNER/ DOCTOR",
"AuthorizedOfficialNamePrefix": "DR.",
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"AuthorizedOfficialCredential": "DC",
"AuthorizedOfficialTelephoneNumber": "906-523-5610",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "111N00000X",
"TaxonomyName": "Chiropractor",
"LicenseNumber": null,
"LicenseNumberStateCode": null,
"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."
}
}
}
}