{
"Npi": {
"NPI": "1235649930",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "ADJUSTED FOR LIFE FAMILY CHIROPRACTIC LLC",
"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": "408 VALLEY ST",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "LATHROP",
"MailingAddressStateName": "MO",
"MailingAddressPostalCode": "64465-9203",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "620-290-0349",
"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "105 S JEFFERSON ST STE B3",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "KEARNEY",
"PracticeLocationAddressStateName": "MO",
"PracticeLocationAddressPostalCode": "64060-8833",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "816-281-8300",
"PracticeLocationAddressFaxNumber": null,
"EnumerationDate": "10/07/2017",
"LastUpdateDate": "10/07/2017",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "SHELDEN",
"AuthorizedOfficialFirstName": "ZOE",
"AuthorizedOfficialMiddleName": null,
"AuthorizedOfficialTitle": "OWNER/DOCTOR OF CHIROPRACTIC",
"AuthorizedOfficialNamePrefix": "DR.",
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "D.C.",
"AuthorizedOfficialTelephoneNumber": "620-290-0349",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "111N00000X",
"TaxonomyName": "Chiropractor",
"LicenseNumber": "2017031033",
"LicenseNumberStateCode": "MO",
"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."
}
}
}
}