NPI Code Detail JSON Logo

1194884098 NPI number — DAVID ALLEN ZELLER JR. MPAS PA-C, APA, CCHP

NPI Number: 1194884098
Health Care Provider/Practitioner: DAVID ALLEN ZELLER JR. MPAS PA-C, APA, CCHP

Information about “1194884098” NPI (DAVID ALLEN ZELLER JR. MPAS PA-C, APA, CCHP) exists in 1194884098 in HTML format HTML  |  1194884098 in plain Text format TXT  |  1194884098 in PDF (Portable Document Format) PDF  |  1194884098 in an XML format XML  formats.

NPI Number : 1194884098 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1194884098",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "N",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "ZELLER",
    "FirstName": "DAVID",
    "MiddleName": "ALLEN",
    "NamePrefix": "MR.",
    "NameSuffix": "JR.",
    "Credential": "MPAS PA-C, APA, CCHP",
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": null,
    "OtherFirstName": null,
    "OtherMiddleName": null,
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": null,
    "FirstLineMailingAddress": "PO BOX 1084",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "BRANDON",
    "MailingAddressStateName": "FL",
    "MailingAddressPostalCode": "33509-1084",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "253-677-7655",
    "MailingAddressFaxNumber": null,
    "FirstLinePracticeLocationAddress": "2480 LLEWELLYN AVE STE 5800",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "FORT MEADE",
    "PracticeLocationAddressStateName": "MD",
    "PracticeLocationAddressPostalCode": "20755-5129",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "253-677-7655",
    "PracticeLocationAddressFaxNumber": null,
    "EnumerationDate": "12/06/2006",
    "LastUpdateDate": "10/27/2020",
    "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": "363A00000X",
          "TaxonomyName": "Physician Assistant",
          "LicenseNumber": "C07116",
          "LicenseNumberStateCode": "MD",
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "363A00000X",
          "TaxonomyName": "Physician Assistant",
          "LicenseNumber": "PA60277854",
          "LicenseNumberStateCode": "WA",
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "363A00000X",
          "TaxonomyName": "Physician Assistant",
          "LicenseNumber": null,
          "LicenseNumberStateCode": null,
          "PrimaryTaxonomySwitch": "Y"
        }
      ]
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

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