NPI Code Detail JSON Logo

1306363635 NPI number — NEPHROMED ASSOCIATES PA

NPI Number: 1306363635
Health Care Provider/Practitioner: NEPHROMED ASSOCIATES PA

Information about “1306363635” NPI (NEPHROMED ASSOCIATES PA) exists in 1306363635 in HTML format HTML  |  1306363635 in plain Text format TXT  |  1306363635 in PDF (Portable Document Format) PDF  |  1306363635 in an XML format XML  formats.

NPI Number : 1306363635 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1306363635",
    "EntityType": "Organization",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": null,
    "IsOrgSubpart": "N",
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": "NEPHROMED ASSOCIATES PA",
    "LastName": null,
    "FirstName": null,
    "MiddleName": null,
    "NamePrefix": null,
    "NameSuffix": null,
    "Credential": null,
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": "6",
    "OtherLastName": null,
    "OtherFirstName": null,
    "OtherMiddleName": null,
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": null,
    "FirstLineMailingAddress": "4002 S LOOP 256",
    "SecondLineMailingAddress": "F",
    "MailingAddressCityName": "PALESTINE",
    "MailingAddressStateName": "TX",
    "MailingAddressPostalCode": "75801-8493",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": null,
    "MailingAddressFaxNumber": null,
    "FirstLinePracticeLocationAddress": "4002 S LOOP 256",
    "SecondLinePracticeLocationAddress": "STE F",
    "PracticeLocationAddressCityName": "PALESTINE",
    "PracticeLocationAddressStateName": "TX",
    "PracticeLocationAddressPostalCode": "75801-8493",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "903-723-8210",
    "PracticeLocationAddressFaxNumber": null,
    "EnumerationDate": "08/28/2017",
    "LastUpdateDate": "05/08/2025",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": null,
    "Gender": null,
    "AuthorizedOfficialLastName": "ADEWALE",
    "AuthorizedOfficialFirstName": "MODINAT",
    "AuthorizedOfficialMiddleName": null,
    "AuthorizedOfficialTitle": "PRACTICE MANAGER",
    "AuthorizedOfficialNamePrefix": "MRS.",
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": null,
    "AuthorizedOfficialTelephoneNumber": "903-729-1071",
    "Taxonomies": {
      "Taxonomy": [
        {
          "TaxonomyCode": "343800000X",
          "TaxonomyName": "Secured Medical Transport (VAN)",
          "LicenseNumber": null,
          "LicenseNumberStateCode": null,
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "207RN0300X",
          "TaxonomyName": "Nephrology Physician",
          "LicenseNumber": null,
          "LicenseNumberStateCode": null,
          "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."
      }
    }
  }
}
                
            

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