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1336683358 NPI number — JON RICHARD TAPIO BOC ORTHOTIST

NPI Number: 1336683358
Health Care Provider/Practitioner: JON RICHARD TAPIO BOC ORTHOTIST

Information about “1336683358” NPI (JON RICHARD TAPIO BOC ORTHOTIST) exists in 1336683358 in HTML format HTML  |  1336683358 in plain Text format TXT  |  1336683358 in PDF (Portable Document Format) PDF  |  1336683358 in an XML format XML  formats.

NPI Number : 1336683358 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1336683358",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "Y",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "TAPIO",
    "FirstName": "JON",
    "MiddleName": "RICHARD",
    "NamePrefix": null,
    "NameSuffix": null,
    "Credential": "BOC ORTHOTIST",
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": null,
    "OtherFirstName": null,
    "OtherMiddleName": null,
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": null,
    "FirstLineMailingAddress": "431 FRONT STREET",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "REPUBLIC",
    "MailingAddressStateName": "MI",
    "MailingAddressPostalCode": "49879",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "906-376-8000",
    "MailingAddressFaxNumber": "616-884-8119",
    "FirstLinePracticeLocationAddress": "431 FRONT STREET",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "REPUBLIC",
    "PracticeLocationAddressStateName": "MI",
    "PracticeLocationAddressPostalCode": "49879",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "906-376-8000",
    "PracticeLocationAddressFaxNumber": "616-884-8119",
    "EnumerationDate": "12/09/2016",
    "LastUpdateDate": "01/10/2018",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": "M",
    "Gender": "Male",
    "AuthorizedOfficialLastName": null,
    "AuthorizedOfficialFirstName": null,
    "AuthorizedOfficialMiddleName": null,
    "AuthorizedOfficialTitle": null,
    "AuthorizedOfficialNamePrefix": null,
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": null,
    "AuthorizedOfficialTelephoneNumber": null,
    "Taxonomies": {
      "Taxonomy": [
        {
          "TaxonomyCode": "246Y00000X",
          "TaxonomyName": "Health Information Specialist/Technologist",
          "LicenseNumber": "EIN81-4646362",
          "LicenseNumberStateCode": "MI",
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "222Z00000X",
          "TaxonomyName": "Orthotist",
          "LicenseNumber": null,
          "LicenseNumberStateCode": null,
          "PrimaryTaxonomySwitch": "Y"
        }
      ]
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

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