{
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"EIN": null,
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"IsOrgSubpart": "N",
"ParentOrgLBN": null,
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"OrgName": "SMITH CHIROPRACTIC CENTER AT ARROWHEAD",
"LastName": null,
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"NamePrefix": null,
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"Credential": null,
"OtherOrgName": null,
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"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "PO BOX 11543",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "GLENDALE",
"MailingAddressStateName": "AZ",
"MailingAddressPostalCode": "85318-1543",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "602-789-8600",
"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "18275 N 59TH AVE STE F134",
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"PracticeLocationAddressCityName": "GLENDALE",
"PracticeLocationAddressStateName": "AZ",
"PracticeLocationAddressPostalCode": "85308-1281",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "602-789-8600",
"PracticeLocationAddressFaxNumber": "602-789-8601",
"EnumerationDate": "09/28/2010",
"LastUpdateDate": "06/28/2017",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "SMITH",
"AuthorizedOfficialFirstName": "JENNIFER",
"AuthorizedOfficialMiddleName": "M",
"AuthorizedOfficialTitle": "OWNER",
"AuthorizedOfficialNamePrefix": "DR.",
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"AuthorizedOfficialCredential": "DC",
"AuthorizedOfficialTelephoneNumber": "602-789-8600",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "111N00000X",
"TaxonomyName": "Chiropractor",
"LicenseNumber": "5840",
"LicenseNumberStateCode": "AZ",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": {
"HealthcareProviderTaxonomyGroup": {
"HealthcareProviderTaxonomyGroupName": "193400000X 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."
}
}
}
}