1235142191 NPI number — JOHN PATRICK BUCHANAN L.I.S.W.

NPI Number: 1235142191
Health Care Provider/Practitioner: JOHN PATRICK BUCHANAN L.I.S.W.

NPI Number : 1235142191 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1235142191",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "N",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "BUCHANAN",
    "FirstName": "JOHN",
    "MiddleName": "PATRICK",
    "NamePrefix": "MR.",
    "NameSuffix": null,
    "Credential": "L.I.S.W.",
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": null,
    "OtherFirstName": null,
    "OtherMiddleName": null,
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": null,
    "FirstLineMailingAddress": "1901 SOL RIO CT NW",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "ALBUQUERQUE",
    "MailingAddressStateName": "NM",
    "MailingAddressPostalCode": "87107-3070",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "505-345-3725",
    "MailingAddressFaxNumber": null,
    "FirstLinePracticeLocationAddress": "6729 4TH ST NW",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "ALBUQUERQUE",
    "PracticeLocationAddressStateName": "NM",
    "PracticeLocationAddressPostalCode": "87107-6114",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "505-342-4678",
    "PracticeLocationAddressFaxNumber": "505-242-4739",
    "EnumerationDate": "08/14/2006",
    "LastUpdateDate": "07/08/2007",
    "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": "1041C0700X",
          "TaxonomyName": "Clinical Social Worker",
          "LicenseNumber": "I-3898",
          "LicenseNumberStateCode": "NM",
          "PrimaryTaxonomySwitch": "Y"
        },
        {
          "TaxonomyCode": "1041C0700X",
          "TaxonomyName": "Clinical Social Worker",
          "LicenseNumber": "LSW0000004290",
          "LicenseNumberStateCode": "TN",
          "PrimaryTaxonomySwitch": "N"
        }
      ]
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}