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1144733973 NPI number — GARRETT MAXWELL ADELMAN A.T.C.

NPI Number: 1144733973
Health Care Provider/Practitioner: GARRETT MAXWELL ADELMAN A.T.C.

Information about “1144733973” NPI (GARRETT MAXWELL ADELMAN A.T.C.) exists in 1144733973 in HTML format HTML  |  1144733973 in plain Text format TXT  |  1144733973 in PDF (Portable Document Format) PDF  |  1144733973 in an XML format XML  formats.

NPI Number : 1144733973 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1144733973",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "Y",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "ADELMAN",
    "FirstName": "GARRETT",
    "MiddleName": "MAXWELL",
    "NamePrefix": null,
    "NameSuffix": null,
    "Credential": "A.T.C.",
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": null,
    "OtherFirstName": null,
    "OtherMiddleName": null,
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": null,
    "FirstLineMailingAddress": "1401 HANSON LN",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "RAMONA",
    "MailingAddressStateName": "CA",
    "MailingAddressPostalCode": "92065-3398",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "760-787-4131",
    "MailingAddressFaxNumber": null,
    "FirstLinePracticeLocationAddress": "1401 HANSON LN",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "RAMONA",
    "PracticeLocationAddressStateName": "CA",
    "PracticeLocationAddressPostalCode": "92065-3398",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "760-787-4131",
    "PracticeLocationAddressFaxNumber": null,
    "EnumerationDate": "11/15/2017",
    "LastUpdateDate": "12/17/2020",
    "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": "2255A2300X",
        "TaxonomyName": "Athletic Trainer",
        "LicenseNumber": "2000031758",
        "LicenseNumberStateCode": "CA",
        "PrimaryTaxonomySwitch": "Y"
      }
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

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