1396838702 NPI number — GREGORY BRADFORD CHATTERTON R.PH. C.PH.

NPI Number: 1396838702
Health Care Provider/Practitioner: GREGORY BRADFORD CHATTERTON R.PH. C.PH.

NPI Number : 1396838702 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1396838702",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "Y",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "CHATTERTON",
    "FirstName": "GREGORY",
    "MiddleName": "BRADFORD",
    "NamePrefix": "MR.",
    "NameSuffix": null,
    "Credential": "R.PH. C.PH.",
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": null,
    "OtherFirstName": null,
    "OtherMiddleName": null,
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": null,
    "FirstLineMailingAddress": "21197 WHITE OAK AVE",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "BOCA RATON",
    "MailingAddressStateName": "FL",
    "MailingAddressPostalCode": "33428-1716",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "561-716-1127",
    "MailingAddressFaxNumber": "561-487-6043",
    "FirstLinePracticeLocationAddress": "21197 WHITE OAK AVE",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "BOCA RATON",
    "PracticeLocationAddressStateName": "FL",
    "PracticeLocationAddressPostalCode": "33428-1716",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "561-716-1127",
    "PracticeLocationAddressFaxNumber": "561-487-6043",
    "EnumerationDate": "09/30/2006",
    "LastUpdateDate": "05/09/2011",
    "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": "183500000X",
        "TaxonomyName": "Pharmacist",
        "LicenseNumber": "PS18239",
        "LicenseNumberStateCode": "FL",
        "PrimaryTaxonomySwitch": "Y"
      }
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}