{
"Npi": {
"NPI": "1194215400",
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"EIN": null,
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"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "RANIER PHYSICAL THERAPY, PLLC",
"LastName": null,
"FirstName": null,
"MiddleName": null,
"NamePrefix": null,
"NameSuffix": null,
"Credential": null,
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"OtherCredential": null,
"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "216 DIVISION ST",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "BELLEVUE",
"MailingAddressStateName": "KY",
"MailingAddressPostalCode": "41073-1179",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "859-916-1334",
"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "3755 OLD KY 17",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "FORT WRIGHT",
"PracticeLocationAddressStateName": "KY",
"PracticeLocationAddressPostalCode": "41017",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "859-916-1334",
"PracticeLocationAddressFaxNumber": null,
"EnumerationDate": "05/11/2018",
"LastUpdateDate": "05/11/2018",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "GARDINIER",
"AuthorizedOfficialFirstName": "RAYMOND",
"AuthorizedOfficialMiddleName": null,
"AuthorizedOfficialTitle": "OWNER/PHYSICAL THERAPIST",
"AuthorizedOfficialNamePrefix": "DR.",
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "PT, DPT, CSCS",
"AuthorizedOfficialTelephoneNumber": "859-916-1334",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "225100000X",
"TaxonomyName": "Physical Therapist",
"LicenseNumber": "007342",
"LicenseNumberStateCode": "KY",
"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."
}
}
}
}