{
"Npi": {
"NPI": "1154477206",
"EntityType": "Individual",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": "Y",
"IsOrgSubpart": null,
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": null,
"LastName": "TSCHANZ",
"FirstName": "MARK",
"MiddleName": "PETER",
"NamePrefix": "DR.",
"NameSuffix": null,
"Credential": "D.O.",
"OtherOrgName": null,
"OtherOrgNameTypeCode": null,
"OtherLastName": null,
"OtherFirstName": null,
"OtherMiddleName": null,
"OtherNamePrefix": null,
"OtherNameSuffix": null,
"OtherCredential": null,
"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "NMRTC PORTSMOUTH",
"SecondLineMailingAddress": "620 JOHN PAUL JONES CIRCLE",
"MailingAddressCityName": "PORTSMOUTH",
"MailingAddressStateName": "VA",
"MailingAddressPostalCode": "23708",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": null,
"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "NMRTC PORTSMOUTH",
"SecondLinePracticeLocationAddress": "620 JOHN PAUL JONES CIRCLE",
"PracticeLocationAddressCityName": "PORTSMOUTH",
"PracticeLocationAddressStateName": "VA",
"PracticeLocationAddressPostalCode": "23708",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "619-532-8225",
"PracticeLocationAddressFaxNumber": null,
"EnumerationDate": "01/25/2007",
"LastUpdateDate": "08/15/2023",
"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": "207R00000X",
"TaxonomyName": "Internal Medicine Physician",
"LicenseNumber": "20A1015",
"LicenseNumberStateCode": "CA",
"PrimaryTaxonomySwitch": "N"
},
{
"TaxonomyCode": "207R00000X",
"TaxonomyName": "Internal Medicine Physician",
"LicenseNumber": "0102207196",
"LicenseNumberStateCode": "VA",
"PrimaryTaxonomySwitch": "Y"
}
]
},
"HealthcareProviderTaxonomyGroups": null
}
}