{
"Npi": {
"NPI": "1326266131",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "ELIZABETH SWIDA SKILLEN, DC, A CHIROPRACTIC CORP.",
"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": "4550 COFFEE RD",
"SecondLineMailingAddress": "SUITE H",
"MailingAddressCityName": "BAKERSFIELD",
"MailingAddressStateName": "CA",
"MailingAddressPostalCode": "93308-5023",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "661-587-0700",
"MailingAddressFaxNumber": "661-587-0799",
"FirstLinePracticeLocationAddress": "4550 COFFEE RD",
"SecondLinePracticeLocationAddress": "SUITE H",
"PracticeLocationAddressCityName": "BAKERSFIELD",
"PracticeLocationAddressStateName": "CA",
"PracticeLocationAddressPostalCode": "93308-5023",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "661-587-0700",
"PracticeLocationAddressFaxNumber": "661-587-0799",
"EnumerationDate": "04/24/2007",
"LastUpdateDate": "08/22/2020",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "SWIDA SKILLEN",
"AuthorizedOfficialFirstName": "ELIZABETH",
"AuthorizedOfficialMiddleName": null,
"AuthorizedOfficialTitle": "OWNER PRESIDENT",
"AuthorizedOfficialNamePrefix": null,
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "DC",
"AuthorizedOfficialTelephoneNumber": "661-587-0700",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "111N00000X",
"TaxonomyName": "Chiropractor",
"LicenseNumber": "DC13886",
"LicenseNumberStateCode": "CA",
"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."
}
}
}
}