{
"Npi": {
"NPI": "1407659998",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "Y",
"ParentOrgLBN": "GOODNESS HEALTH, LLC",
"ParentOrgTIN": null,
"OrgName": "GOODNESS HEALTH, LLC",
"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": "680 N CLARKSON ST",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "DENVER",
"MailingAddressStateName": "CO",
"MailingAddressPostalCode": "80218-3202",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "720-500-5488",
"MailingAddressFaxNumber": "866-880-7184",
"FirstLinePracticeLocationAddress": "759 E PAGES LN",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "CENTERVILLE",
"PracticeLocationAddressStateName": "UT",
"PracticeLocationAddressPostalCode": "84014-2556",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "720-500-5488",
"PracticeLocationAddressFaxNumber": "866-880-7184",
"EnumerationDate": "03/31/2025",
"LastUpdateDate": "03/31/2025",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "HUNTZINGER",
"AuthorizedOfficialFirstName": "MICAH",
"AuthorizedOfficialMiddleName": null,
"AuthorizedOfficialTitle": "CEO",
"AuthorizedOfficialNamePrefix": null,
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": null,
"AuthorizedOfficialTelephoneNumber": "720-500-5488",
"Taxonomies": {
"Taxonomy": [
{
"TaxonomyCode": "363LG0600X",
"TaxonomyName": "Gerontology Nurse Practitioner",
"LicenseNumber": null,
"LicenseNumberStateCode": null,
"PrimaryTaxonomySwitch": "N"
},
{
"TaxonomyCode": "207R00000X",
"TaxonomyName": "Internal 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."
}
]
}
}
}