{
"Npi": {
"NPI": "1316179153",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "ACUPUNCTURE & INTEGRATIVE HEALTH CARE OF ARIZONA 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": "16842 E PARKVIEW AVE",
"SecondLineMailingAddress": "SUITE 2",
"MailingAddressCityName": "FOUNTAIN HILLS",
"MailingAddressStateName": "AZ",
"MailingAddressPostalCode": "85268-3825",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "631-707-2044",
"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "16842 E PARKVIEW AVE",
"SecondLinePracticeLocationAddress": "SUITE 2",
"PracticeLocationAddressCityName": "FOUNTAIN HILLS",
"PracticeLocationAddressStateName": "AZ",
"PracticeLocationAddressPostalCode": "85268-3825",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "631-707-2044",
"PracticeLocationAddressFaxNumber": null,
"EnumerationDate": "08/12/2009",
"LastUpdateDate": "08/12/2009",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "MCELDERRY",
"AuthorizedOfficialFirstName": "PAUL",
"AuthorizedOfficialMiddleName": "ALAN",
"AuthorizedOfficialTitle": "OWNER/PRACTITIONER",
"AuthorizedOfficialNamePrefix": null,
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "L.AC., LMT, MS",
"AuthorizedOfficialTelephoneNumber": "631-707-2044",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "171100000X",
"TaxonomyName": "Acupuncturist",
"LicenseNumber": "0647",
"LicenseNumberStateCode": "AZ",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": {
"HealthcareProviderTaxonomyGroup": {
"HealthcareProviderTaxonomyGroupName": "193200000X MULTI-SPECIALTY GROUP",
"HealthcareProviderTaxonomyGroupDescription": "Multi-Specialty Group - A business group of one or more individual practitioners, who practice with different areas of specialization."
}
}
}
}