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1215906029 NPI number — JOHN M GORUP MD

NPI Number: 1215906029
Health Care Provider/Practitioner: JOHN M GORUP MD

Information about “1215906029” NPI (JOHN M GORUP MD) exists in 1215906029 in HTML format HTML  |  1215906029 in plain Text format TXT  |  1215906029 in PDF (Portable Document Format) PDF  |  1215906029 in an XML format XML  formats.

NPI Number : 1215906029 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1215906029",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "N",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "GORUP",
    "FirstName": "JOHN",
    "MiddleName": "M",
    "NamePrefix": null,
    "NameSuffix": null,
    "Credential": "MD",
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": null,
    "OtherFirstName": null,
    "OtherMiddleName": null,
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": null,
    "FirstLineMailingAddress": "13225 N MERIDIAN ST",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "CARMEL",
    "MailingAddressStateName": "IN",
    "MailingAddressPostalCode": "46032-5480",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "317-228-7000",
    "MailingAddressFaxNumber": "317-228-2321",
    "FirstLinePracticeLocationAddress": "1345 UNITY PL STE 310",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "LAFAYETTE",
    "PracticeLocationAddressStateName": "IN",
    "PracticeLocationAddressPostalCode": "47905-5769",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "765-446-5210",
    "PracticeLocationAddressFaxNumber": "765-446-5211",
    "EnumerationDate": "03/15/2006",
    "LastUpdateDate": "06/24/2025",
    "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": "207XS0117X",
        "TaxonomyName": "Orthopaedic Surgery of the Spine Physician",
        "LicenseNumber": "01046921A",
        "LicenseNumberStateCode": "IN",
        "PrimaryTaxonomySwitch": "Y"
      }
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

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