{
"Npi": {
"NPI": "1437053063",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "DA VINCI INNOVATIONS LLC",
"LastName": null,
"FirstName": null,
"MiddleName": null,
"NamePrefix": null,
"NameSuffix": null,
"Credential": null,
"OtherOrgName": null,
"OtherOrgNameTypeCode": "6",
"OtherLastName": null,
"OtherFirstName": null,
"OtherMiddleName": null,
"OtherNamePrefix": null,
"OtherNameSuffix": null,
"OtherCredential": null,
"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "3832 LAKESHORE DR",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "METAIRIE",
"MailingAddressStateName": "LA",
"MailingAddressPostalCode": "70002-1419",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "504-339-2048",
"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "1 GALLERIA BLVD STE 710C",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "METAIRIE",
"PracticeLocationAddressStateName": "LA",
"PracticeLocationAddressPostalCode": "70001-7592",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "504-345-2721",
"PracticeLocationAddressFaxNumber": null,
"EnumerationDate": "10/06/2026",
"LastUpdateDate": "10/06/2026",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "PROVENZANO",
"AuthorizedOfficialFirstName": "MARK",
"AuthorizedOfficialMiddleName": null,
"AuthorizedOfficialTitle": "CFO",
"AuthorizedOfficialNamePrefix": null,
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": null,
"AuthorizedOfficialTelephoneNumber": "504-339-2048",
"Taxonomies": {
"Taxonomy": [
{
"TaxonomyCode": "332U00000X",
"TaxonomyName": "Home Delivered Meals",
"LicenseNumber": null,
"LicenseNumberStateCode": "NULL",
"PrimaryTaxonomySwitch": "N"
},
{
"TaxonomyCode": "174200000X",
"TaxonomyName": "Meals Provider",
"LicenseNumber": null,
"LicenseNumberStateCode": "NULL",
"PrimaryTaxonomySwitch": "Y"
},
{
"TaxonomyCode": "3336C0004X",
"TaxonomyName": "Compounding Pharmacy",
"LicenseNumber": null,
"LicenseNumberStateCode": "NULL",
"PrimaryTaxonomySwitch": "N"
}
]
},
"HealthcareProviderTaxonomyGroups": null
}
}