{
"Npi": {
"NPI": "1386837722",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "SMITH CHIROPRACTIC PAIN CENTER PC",
"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": "2609 CANTRELL RD",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "HARRISONVILLE",
"MailingAddressStateName": "MO",
"MailingAddressPostalCode": "64701-4002",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "816-380-3860",
"MailingAddressFaxNumber": "816-380-3862",
"FirstLinePracticeLocationAddress": "2609 CANTRELL RD",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "HARRISONVILLE",
"PracticeLocationAddressStateName": "MO",
"PracticeLocationAddressPostalCode": "64701-4002",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "816-380-3860",
"PracticeLocationAddressFaxNumber": "816-380-3862",
"EnumerationDate": "08/20/2007",
"LastUpdateDate": "10/11/2007",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "SMITH",
"AuthorizedOfficialFirstName": "TYRONE",
"AuthorizedOfficialMiddleName": "PRESCOTT",
"AuthorizedOfficialTitle": "PRESIDENT",
"AuthorizedOfficialNamePrefix": "DR.",
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "D.C.",
"AuthorizedOfficialTelephoneNumber": "816-380-3860",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "261Q00000X",
"TaxonomyName": "Clinic/Center",
"LicenseNumber": "2002019357",
"LicenseNumberStateCode": "MO",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}