{
"Npi": {
"NPI": "1376367565",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "HEALTHPATHWAYS TN, 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": "PO BOX 223187",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "HOLLYWOOD",
"MailingAddressStateName": "FL",
"MailingAddressPostalCode": "33022-3187",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "954-445-1461",
"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "3609 OUTDOOR SPORTSMAN PL",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "KODAK",
"PracticeLocationAddressStateName": "TN",
"PracticeLocationAddressPostalCode": "37764-1476",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "954-526-5165",
"PracticeLocationAddressFaxNumber": null,
"EnumerationDate": "11/13/2024",
"LastUpdateDate": "11/13/2024",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "NARANJO",
"AuthorizedOfficialFirstName": "JULIAN",
"AuthorizedOfficialMiddleName": "F",
"AuthorizedOfficialTitle": "DIRECTOR",
"AuthorizedOfficialNamePrefix": null,
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "MD",
"AuthorizedOfficialTelephoneNumber": "954-445-1461",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "208VP0014X",
"TaxonomyName": "Interventional Pain Medicine Physician",
"LicenseNumber": null,
"LicenseNumberStateCode": null,
"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."
}
}
}
}