1386952273 NPI number — DAVID JENNINGS PT, DPT, SCS, CMTPT

NPI Number: 1386952273
Health Care Provider/Practitioner: DAVID JENNINGS PT, DPT, SCS, CMTPT

NPI Number : 1386952273 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1386952273",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "N",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "JENNINGS",
    "FirstName": "DAVID",
    "MiddleName": null,
    "NamePrefix": null,
    "NameSuffix": null,
    "Credential": "PT, DPT, SCS, CMTPT",
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": null,
    "OtherFirstName": null,
    "OtherMiddleName": null,
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": null,
    "FirstLineMailingAddress": "152 BURBERRY GLEN BLVD",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "NOLENSVILLE",
    "MailingAddressStateName": "TN",
    "MailingAddressPostalCode": "37135-2102",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "615-878-7595",
    "MailingAddressFaxNumber": null,
    "FirstLinePracticeLocationAddress": "615 BAKERS BRIDGE AVE STE 110",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "FRANKLIN",
    "PracticeLocationAddressStateName": "TN",
    "PracticeLocationAddressPostalCode": "37067-1801",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "615-465-6810",
    "PracticeLocationAddressFaxNumber": "615-465-6817",
    "EnumerationDate": "09/14/2010",
    "LastUpdateDate": "09/16/2019",
    "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": "2255A2300X",
          "TaxonomyName": "Athletic Trainer",
          "LicenseNumber": "1386",
          "LicenseNumberStateCode": "TN",
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "2251S0007X",
          "TaxonomyName": "Sports Physical Therapist",
          "LicenseNumber": "10483",
          "LicenseNumberStateCode": "TN",
          "PrimaryTaxonomySwitch": "Y"
        }
      ]
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}