{
"Npi": {
"NPI": "1306389598",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "HEALING HANDS CHIROPRACTIC CENTER, PLLC",
"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": "1873 WESTERN AVE",
"SecondLineMailingAddress": "SUITE 103",
"MailingAddressCityName": "ALBANY",
"MailingAddressStateName": "NY",
"MailingAddressPostalCode": "12203-5028",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "518-869-8000",
"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "1873 WESTERN AVE",
"SecondLinePracticeLocationAddress": "SUITE 103",
"PracticeLocationAddressCityName": "ALBANY",
"PracticeLocationAddressStateName": "NY",
"PracticeLocationAddressPostalCode": "12203-5028",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "518-869-8000",
"PracticeLocationAddressFaxNumber": "518-869-8009",
"EnumerationDate": "11/21/2016",
"LastUpdateDate": "12/05/2022",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "DIAMOND",
"AuthorizedOfficialFirstName": "JESSICA",
"AuthorizedOfficialMiddleName": "MARIE",
"AuthorizedOfficialTitle": "OWNER/PRESIDENT/PROVIDER",
"AuthorizedOfficialNamePrefix": null,
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "DC",
"AuthorizedOfficialTelephoneNumber": "518-869-8000",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "302R00000X",
"TaxonomyName": "Health Maintenance Organization",
"LicenseNumber": "X0128751",
"LicenseNumberStateCode": "NY",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}