{
"Npi": {
"NPI": "1194148452",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "ACUPUNCTURE AND HERBAL HEALTH AND WELLNESS, INC.",
"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": "214 S IOWA AVE",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "WASHINGTON",
"MailingAddressStateName": "IA",
"MailingAddressPostalCode": "52353-1753",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "319-430-2810",
"MailingAddressFaxNumber": "319-356-0116",
"FirstLinePracticeLocationAddress": "214 S IOWA AVE",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "WASHINGTON",
"PracticeLocationAddressStateName": "IA",
"PracticeLocationAddressPostalCode": "52353-1753",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "319-430-2810",
"PracticeLocationAddressFaxNumber": "319-356-0116",
"EnumerationDate": "01/22/2014",
"LastUpdateDate": "01/22/2014",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "DUSTERHOFT",
"AuthorizedOfficialFirstName": "SUE",
"AuthorizedOfficialMiddleName": "A",
"AuthorizedOfficialTitle": "PRESIDENT",
"AuthorizedOfficialNamePrefix": "MS.",
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "DIPL. O.M.",
"AuthorizedOfficialTelephoneNumber": "319-430-2810",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "171100000X",
"TaxonomyName": "Acupuncturist",
"LicenseNumber": "A-54",
"LicenseNumberStateCode": "IA",
"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."
}
}
}
}