NPI Code Detail JSON Logo

1225169196 NPI number — PEDIATRIC PULMONARY & CRITICAL CARE, PC

NPI Number: 1225169196
Health Care Provider/Practitioner: PEDIATRIC PULMONARY & CRITICAL CARE, PC

Information about “1225169196” NPI (PEDIATRIC PULMONARY & CRITICAL CARE, PC) exists in 1225169196 in HTML format HTML  |  1225169196 in plain Text format TXT  |  1225169196 in PDF (Portable Document Format) PDF  |  1225169196 in an XML format XML  formats.

NPI Number : 1225169196 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1225169196",
    "EntityType": "Organization",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": null,
    "IsOrgSubpart": "N",
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": "PEDIATRIC PULMONARY & CRITICAL CARE, PC",
    "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": "PMB 218 10214 CHESTNUT PLAZA DRIVE",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "FORT WAYNE",
    "MailingAddressStateName": "IN",
    "MailingAddressPostalCode": "46814-8970",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "260-435-7800",
    "MailingAddressFaxNumber": "260-435-7007",
    "FirstLinePracticeLocationAddress": "7910 WEST JEFFERSON BLVD.",
    "SecondLinePracticeLocationAddress": "STE 205",
    "PracticeLocationAddressCityName": "FORT WAYNE",
    "PracticeLocationAddressStateName": "IN",
    "PracticeLocationAddressPostalCode": "46804-4159",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "260-435-7800",
    "PracticeLocationAddressFaxNumber": "260-435-7007",
    "EnumerationDate": "03/09/2007",
    "LastUpdateDate": "03/06/2012",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": null,
    "Gender": null,
    "AuthorizedOfficialLastName": "YALAMANCHALI",
    "AuthorizedOfficialFirstName": "CHANDRASHEKHAR",
    "AuthorizedOfficialMiddleName": "CHOWDARY",
    "AuthorizedOfficialTitle": "OWNER/PRESIDENT",
    "AuthorizedOfficialNamePrefix": null,
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": "M.D.",
    "AuthorizedOfficialTelephoneNumber": "260-435-7800",
    "Taxonomies": {
      "Taxonomy": [
        {
          "TaxonomyCode": "208000000X",
          "TaxonomyName": "Pediatrics Physician",
          "LicenseNumber": null,
          "LicenseNumberStateCode": null,
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "2080P0203X",
          "TaxonomyName": "Pediatric Critical Care Medicine Physician",
          "LicenseNumber": null,
          "LicenseNumberStateCode": null,
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "2080P0214X",
          "TaxonomyName": "Pediatric Pulmonology Physician",
          "LicenseNumber": null,
          "LicenseNumberStateCode": null,
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "2080P0203X",
          "TaxonomyName": "Pediatric Critical Care Medicine Physician",
          "LicenseNumber": "01049779A",
          "LicenseNumberStateCode": "IN",
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "2080P0214X",
          "TaxonomyName": "Pediatric Pulmonology Physician",
          "LicenseNumber": "01049779A",
          "LicenseNumberStateCode": "IN",
          "PrimaryTaxonomySwitch": "Y"
        }
      ]
    },
    "HealthcareProviderTaxonomyGroups": {
      "HealthcareProviderTaxonomyGroup": [
        {
          "HealthcareProviderTaxonomyGroupName": "193200000X MULTI-SPECIALTY GROUP",
          "HealthcareProviderTaxonomyGroupDescription": "Multi-Specialty Group - A business group of one or more individual practitioners, who practice with different areas of specialization."
        },
        {
          "HealthcareProviderTaxonomyGroupName": "193200000X MULTI-SPECIALTY GROUP",
          "HealthcareProviderTaxonomyGroupDescription": "Multi-Specialty Group - A business group of one or more individual practitioners, who practice with different areas of specialization."
        },
        {
          "HealthcareProviderTaxonomyGroupName": "193200000X MULTI-SPECIALTY GROUP",
          "HealthcareProviderTaxonomyGroupDescription": "Multi-Specialty Group - A business group of one or more individual practitioners, who practice with different areas of specialization."
        },
        {
          "HealthcareProviderTaxonomyGroupName": "193200000X MULTI-SPECIALTY GROUP",
          "HealthcareProviderTaxonomyGroupDescription": "Multi-Specialty Group - A business group of one or more individual practitioners, who practice with different areas of specialization."
        },
        {
          "HealthcareProviderTaxonomyGroupName": "193200000X MULTI-SPECIALTY GROUP",
          "HealthcareProviderTaxonomyGroupDescription": "Multi-Specialty Group - A business group of one or more individual practitioners, who practice with different areas of specialization."
        }
      ]
    }
  }
}
                
            

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