{
"Npi": {
"NPI": "1154615623",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "DR. JOHN SHANLEY CHIROPRACTIC PHYSICIAN LLC",
"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": "115 MARION PL",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "STEUBENVILLE",
"MailingAddressStateName": "OH",
"MailingAddressPostalCode": "43953-3456",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "740-512-6206",
"MailingAddressFaxNumber": "888-624-8339",
"FirstLinePracticeLocationAddress": "450 MAIN ST",
"SecondLinePracticeLocationAddress": "SUITE B",
"PracticeLocationAddressCityName": "WINTERSVILLE",
"PracticeLocationAddressStateName": "OH",
"PracticeLocationAddressPostalCode": "43953-3770",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "740-512-9763",
"PracticeLocationAddressFaxNumber": "888-624-8339",
"EnumerationDate": "06/02/2011",
"LastUpdateDate": "06/02/2011",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "SHANLEY",
"AuthorizedOfficialFirstName": "JOHN",
"AuthorizedOfficialMiddleName": null,
"AuthorizedOfficialTitle": "CHIROPRACTOR/OWNER",
"AuthorizedOfficialNamePrefix": "DR.",
"AuthorizedOfficialNameSuffix": "JR.",
"AuthorizedOfficialCredential": "D.C.",
"AuthorizedOfficialTelephoneNumber": "740-512-9763",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "111N00000X",
"TaxonomyName": "Chiropractor",
"LicenseNumber": "3670",
"LicenseNumberStateCode": "OH",
"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."
}
}
}
}