{
"Npi": {
"NPI": "1134288913",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "DISCOVER CHIROPRACTIC CENTER, P.C.",
"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": "6550 YORK AVE S",
"SecondLineMailingAddress": "STE 216",
"MailingAddressCityName": "EDINA",
"MailingAddressStateName": "MN",
"MailingAddressPostalCode": "55435-2347",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "952-746-7533",
"MailingAddressFaxNumber": "952-746-7536",
"FirstLinePracticeLocationAddress": "6550 YORK AVE S",
"SecondLinePracticeLocationAddress": "STE 216",
"PracticeLocationAddressCityName": "EDINA",
"PracticeLocationAddressStateName": "MN",
"PracticeLocationAddressPostalCode": "55435-2347",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "952-746-7533",
"PracticeLocationAddressFaxNumber": "952-746-7536",
"EnumerationDate": "12/07/2006",
"LastUpdateDate": "08/22/2020",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "HAKE",
"AuthorizedOfficialFirstName": "WILLIAM",
"AuthorizedOfficialMiddleName": "THOMAS",
"AuthorizedOfficialTitle": "CHIROPRACTOR",
"AuthorizedOfficialNamePrefix": "DR.",
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "D.C.",
"AuthorizedOfficialTelephoneNumber": "952-746-7533",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "261Q00000X",
"TaxonomyName": "Clinic/Center",
"LicenseNumber": "4583",
"LicenseNumberStateCode": "MN",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}