{
"Npi": {
"NPI": "1265850374",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "CLEAR MIND ACUPUNCTURE 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": "5250 E CHERRY CREEK SOUTH DR APT 16J",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "DENVER",
"MailingAddressStateName": "CO",
"MailingAddressPostalCode": "80246-2711",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "303-709-3239",
"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "1325 S COLORADO BLVD STE B012",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "DENVER",
"PracticeLocationAddressStateName": "CO",
"PracticeLocationAddressPostalCode": "80222-3303",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "303-709-3239",
"PracticeLocationAddressFaxNumber": null,
"EnumerationDate": "04/04/2014",
"LastUpdateDate": "04/04/2014",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "LEVY",
"AuthorizedOfficialFirstName": "EVA",
"AuthorizedOfficialMiddleName": null,
"AuthorizedOfficialTitle": "OWNER/ACUPUNCTURIST",
"AuthorizedOfficialNamePrefix": null,
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "L.AC.",
"AuthorizedOfficialTelephoneNumber": "303-709-3239",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "305S00000X",
"TaxonomyName": "Point of Service",
"LicenseNumber": "1864",
"LicenseNumberStateCode": "CO",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}