{
"Npi": {
"NPI": "1396084919",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "Y",
"ParentOrgLBN": "EGAN CHIROPRACTIC AND ACUPUNCTURE LTD",
"ParentOrgTIN": null,
"OrgName": "EGAN CHIROPRACTIC AND ACUPUNCTURE LTD",
"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": "7400 LYNDALE AVE S SUITE 190 #2",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "RICHFIELD",
"MailingAddressStateName": "MN",
"MailingAddressPostalCode": "55423",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "612-590-6812",
"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "7400 LYNDALE AVE S SUITE 190 #2",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "RICHFIELD",
"PracticeLocationAddressStateName": "MN",
"PracticeLocationAddressPostalCode": "55423",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "612-590-6812",
"PracticeLocationAddressFaxNumber": null,
"EnumerationDate": "02/01/2013",
"LastUpdateDate": "02/01/2013",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "EGAN",
"AuthorizedOfficialFirstName": "TIFFANY",
"AuthorizedOfficialMiddleName": null,
"AuthorizedOfficialTitle": "CHIROPRACTOR",
"AuthorizedOfficialNamePrefix": null,
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": null,
"AuthorizedOfficialTelephoneNumber": "612-590-6812",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "111N00000X",
"TaxonomyName": "Chiropractor",
"LicenseNumber": "5729",
"LicenseNumberStateCode": "MN",
"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."
}
}
}
}