NPI Code Detail JSON Logo

1396678009 NPI number — MAGNA HEALTH RESOURCE INC

NPI Number: 1396678009
Health Care Provider/Practitioner: MAGNA HEALTH RESOURCE INC

Information about “1396678009” NPI (MAGNA HEALTH RESOURCE INC) exists in 1396678009 in HTML format HTML  |  1396678009 in plain Text format TXT  |  1396678009 in PDF (Portable Document Format) PDF  |  1396678009 in an XML format XML  formats.

NPI Number : 1396678009 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1396678009",
    "EntityType": "Organization",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": null,
    "IsOrgSubpart": "N",
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": "MAGNA HEALTH RESOURCE INC",
    "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": "6484 LAUREL OAK DR",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "SPRING HILL",
    "MailingAddressStateName": "FL",
    "MailingAddressPostalCode": "34607-2321",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "813-846-7582",
    "MailingAddressFaxNumber": null,
    "FirstLinePracticeLocationAddress": "5401 W KENNEDY BLVD # 166",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "TAMPA",
    "PracticeLocationAddressStateName": "FL",
    "PracticeLocationAddressPostalCode": "33609-2428",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "813-317-1787",
    "PracticeLocationAddressFaxNumber": null,
    "EnumerationDate": "06/04/2026",
    "LastUpdateDate": "06/04/2026",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": null,
    "Gender": null,
    "AuthorizedOfficialLastName": "CLIPPS",
    "AuthorizedOfficialFirstName": "ERICA",
    "AuthorizedOfficialMiddleName": "HARVETTE",
    "AuthorizedOfficialTitle": "DIRECTOR",
    "AuthorizedOfficialNamePrefix": "MRS.",
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": "APRN",
    "AuthorizedOfficialTelephoneNumber": "813-846-7582",
    "Taxonomies": {
      "Taxonomy": [
        {
          "TaxonomyCode": "364SW0102X",
          "TaxonomyName": "Women's Health Clinical Nurse Specialist",
          "LicenseNumber": null,
          "LicenseNumberStateCode": null,
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "163WC1500X",
          "TaxonomyName": "Community Health Registered Nurse",
          "LicenseNumber": null,
          "LicenseNumberStateCode": null,
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "364SP0809X",
          "TaxonomyName": "Adult Psychiatric/Mental Health Clinical Nurse Specialist",
          "LicenseNumber": null,
          "LicenseNumberStateCode": null,
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "207Q00000X",
          "TaxonomyName": "Family 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."
        },
        {
          "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."
        },
        {
          "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."
        },
        {
          "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."
        }
      ]
    }
  }
}
                
            

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