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1417094095 NPI number — SHANA LYNN BELL LPTA

NPI Number: 1417094095
Health Care Provider/Practitioner: SHANA LYNN BELL LPTA

Information about “1417094095” NPI (SHANA LYNN BELL LPTA) exists in 1417094095 in HTML format HTML  |  1417094095 in plain Text format TXT  |  1417094095 in PDF (Portable Document Format) PDF  |  1417094095 in an XML format XML  formats.

NPI Number : 1417094095 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1417094095",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "Y",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "BELL",
    "FirstName": "SHANA",
    "MiddleName": "LYNN",
    "NamePrefix": null,
    "NameSuffix": null,
    "Credential": "LPTA",
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": "GRAHAM",
    "OtherFirstName": "SHANA",
    "OtherMiddleName": "LYNN",
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": "LPTA",
    "OtherLastNameTypeCode": "1",
    "FirstLineMailingAddress": "5 NORTHSIDE DR",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "BELMONT",
    "MailingAddressStateName": "MS",
    "MailingAddressPostalCode": "38827-9201",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "662-416-1049",
    "MailingAddressFaxNumber": "662-284-9866",
    "FirstLinePracticeLocationAddress": "127 PRATT DR",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "CORINTH",
    "PracticeLocationAddressStateName": "MS",
    "PracticeLocationAddressPostalCode": "38834-6026",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "662-284-9838",
    "PracticeLocationAddressFaxNumber": "662-284-9866",
    "EnumerationDate": "01/31/2007",
    "LastUpdateDate": "04/07/2020",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": "F",
    "Gender": "Female",
    "AuthorizedOfficialLastName": null,
    "AuthorizedOfficialFirstName": null,
    "AuthorizedOfficialMiddleName": null,
    "AuthorizedOfficialTitle": null,
    "AuthorizedOfficialNamePrefix": null,
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": null,
    "AuthorizedOfficialTelephoneNumber": null,
    "Taxonomies": {
      "Taxonomy": [
        {
          "TaxonomyCode": "174400000X",
          "TaxonomyName": "Specialist",
          "LicenseNumber": "PTA3102",
          "LicenseNumberStateCode": "MS",
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "261QP2000X",
          "TaxonomyName": "Physical Therapy Clinic/Center",
          "LicenseNumber": null,
          "LicenseNumberStateCode": null,
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "225200000X",
          "TaxonomyName": "Physical Therapy Assistant",
          "LicenseNumber": "PTA3102",
          "LicenseNumberStateCode": "MS",
          "PrimaryTaxonomySwitch": "Y"
        }
      ]
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

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