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1245738970 NPI number — DAVID ABBOTT NMT HMS SMT LMT TIC

NPI Number: 1245738970
Health Care Provider/Practitioner: DAVID ABBOTT NMT HMS SMT LMT TIC

Information about “1245738970” NPI (DAVID ABBOTT NMT HMS SMT LMT TIC) exists in 1245738970 in HTML format HTML  |  1245738970 in plain Text format TXT  |  1245738970 in PDF (Portable Document Format) PDF  |  1245738970 in an XML format XML  formats.

NPI Number : 1245738970 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1245738970",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "Y",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "ABBOTT",
    "FirstName": "DAVID",
    "MiddleName": null,
    "NamePrefix": null,
    "NameSuffix": null,
    "Credential": "NMT HMS SMT LMT TIC",
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": null,
    "OtherFirstName": null,
    "OtherMiddleName": null,
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": null,
    "FirstLineMailingAddress": "2120 ACADEMY CIR STE F",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "COLORADO SPRINGS",
    "MailingAddressStateName": "CO",
    "MailingAddressPostalCode": "80909-1674",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "719-373-3399",
    "MailingAddressFaxNumber": null,
    "FirstLinePracticeLocationAddress": "2120 ACADEMY CIR STE F",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "COLORADO SPRINGS",
    "PracticeLocationAddressStateName": "CO",
    "PracticeLocationAddressPostalCode": "80909-1674",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "719-373-3399",
    "PracticeLocationAddressFaxNumber": null,
    "EnumerationDate": "01/29/2018",
    "LastUpdateDate": "10/05/2022",
    "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": "225400000X",
          "TaxonomyName": "Rehabilitation Practitioner",
          "LicenseNumber": null,
          "LicenseNumberStateCode": null,
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "225700000X",
          "TaxonomyName": "Massage Therapist",
          "LicenseNumber": "MT.0019317",
          "LicenseNumberStateCode": "CO",
          "PrimaryTaxonomySwitch": "Y"
        }
      ]
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

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