{
"Npi": {
"NPI": "1144522400",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "SLAYTON CHIROPRACTIC CLINIC P.A.",
"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": "2002 BROADWAY AVE",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "SLAYTON",
"MailingAddressStateName": "MN",
"MailingAddressPostalCode": "56172-2011",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "507-836-8911",
"MailingAddressFaxNumber": "507-836-8920",
"FirstLinePracticeLocationAddress": "2002 BROADWAY AVE",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "SLAYTON",
"PracticeLocationAddressStateName": "MN",
"PracticeLocationAddressPostalCode": "56172-2011",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "507-836-8911",
"PracticeLocationAddressFaxNumber": "507-836-8920",
"EnumerationDate": "11/18/2010",
"LastUpdateDate": "12/01/2010",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "LINDSTROM",
"AuthorizedOfficialFirstName": "MAE",
"AuthorizedOfficialMiddleName": "BETH",
"AuthorizedOfficialTitle": "OWNER/DOCTOR OF CHIROPRACTIC",
"AuthorizedOfficialNamePrefix": "DR.",
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "D.C.",
"AuthorizedOfficialTelephoneNumber": "507-836-8911",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "111N00000X",
"TaxonomyName": "Chiropractor",
"LicenseNumber": "2724",
"LicenseNumberStateCode": "MN",
"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."
}
}
}
}