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1336491968 NPI number — FASTMED URGENT CARE

NPI Number: 1336491968
Health Care Provider/Practitioner: FASTMED URGENT CARE

Information about “1336491968” NPI (FASTMED URGENT CARE) exists in 1336491968 in HTML format HTML  |  1336491968 in plain Text format TXT  |  1336491968 in PDF (Portable Document Format) PDF  |  1336491968 in an XML format XML  formats.

NPI Number : 1336491968 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1336491968",
    "EntityType": "Organization",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": null,
    "IsOrgSubpart": "N",
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": "FASTMED URGENT CARE",
    "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": "800 W ELLIOT ROAD SUITE 103",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "GILBERT",
    "MailingAddressStateName": "AZ",
    "MailingAddressPostalCode": "85233",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": null,
    "MailingAddressFaxNumber": null,
    "FirstLinePracticeLocationAddress": "890 W ELLIOT RD",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "GILBERT",
    "PracticeLocationAddressStateName": "AZ",
    "PracticeLocationAddressPostalCode": "85233-5102",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "480-585-2787",
    "PracticeLocationAddressFaxNumber": "480-545-1458",
    "EnumerationDate": "10/05/2012",
    "LastUpdateDate": "10/05/2012",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": null,
    "Gender": null,
    "AuthorizedOfficialLastName": "JAMES",
    "AuthorizedOfficialFirstName": "TRUDY",
    "AuthorizedOfficialMiddleName": null,
    "AuthorizedOfficialTitle": "CREDENTIALING SPECIALIST",
    "AuthorizedOfficialNamePrefix": "MISS",
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": null,
    "AuthorizedOfficialTelephoneNumber": "480-585-2787",
    "Taxonomies": {
      "Taxonomy": {
        "TaxonomyCode": "363A00000X",
        "TaxonomyName": "Physician Assistant",
        "LicenseNumber": null,
        "LicenseNumberStateCode": "AZ",
        "PrimaryTaxonomySwitch": "Y"
      }
    },
    "HealthcareProviderTaxonomyGroups": {
      "HealthcareProviderTaxonomyGroup": {
        "HealthcareProviderTaxonomyGroupName": "193400000X MULTIPLE 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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