NPI Code Detail JSON Logo

1447072731 NPI number — CLINICAL PRACTICE OF LECOM INSTITUTE FOR SUCCESSFUL LIVING

NPI Number: 1447072731
Health Care Provider/Practitioner: CLINICAL PRACTICE OF LECOM INSTITUTE FOR SUCCESSFUL LIVING

Information about “1447072731” NPI (CLINICAL PRACTICE OF LECOM INSTITUTE FOR SUCCESSFUL LIVING) exists in 1447072731 in HTML format HTML  |  1447072731 in plain Text format TXT  |  1447072731 in PDF (Portable Document Format) PDF  |  1447072731 in an XML format XML  formats.

NPI Number : 1447072731 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1447072731",
    "EntityType": "Organization",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": null,
    "IsOrgSubpart": "Y",
    "ParentOrgLBN": "MILLCREEK MANOR",
    "ParentOrgTIN": null,
    "OrgName": "CLINICAL PRACTICE OF LECOM INSTITUTE FOR SUCCESSFUL LIVING",
    "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": "5535 PEACH ST",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "ERIE",
    "MailingAddressStateName": "PA",
    "MailingAddressPostalCode": "16509-2603",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "814-844-2858",
    "MailingAddressFaxNumber": null,
    "FirstLinePracticeLocationAddress": "16954 CONNEAUT LAKE RD",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "MEADVILLE",
    "PracticeLocationAddressStateName": "PA",
    "PracticeLocationAddressPostalCode": "16335-3738",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "814-868-2200",
    "PracticeLocationAddressFaxNumber": null,
    "EnumerationDate": "10/28/2024",
    "LastUpdateDate": "02/03/2025",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": null,
    "Gender": null,
    "AuthorizedOfficialLastName": "LIN",
    "AuthorizedOfficialFirstName": "JAMES",
    "AuthorizedOfficialMiddleName": null,
    "AuthorizedOfficialTitle": "PRESIDENT",
    "AuthorizedOfficialNamePrefix": null,
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": null,
    "AuthorizedOfficialTelephoneNumber": "814-602-7783",
    "Taxonomies": {
      "Taxonomy": [
        {
          "TaxonomyCode": "207R00000X",
          "TaxonomyName": "Internal Medicine Physician",
          "LicenseNumber": null,
          "LicenseNumberStateCode": null,
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "207RG0300X",
          "TaxonomyName": "Geriatric Medicine (Internal Medicine) Physician",
          "LicenseNumber": null,
          "LicenseNumberStateCode": null,
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "207RI0011X",
          "TaxonomyName": "Interventional Cardiology Physician",
          "LicenseNumber": null,
          "LicenseNumberStateCode": null,
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "213ES0103X",
          "TaxonomyName": "Foot & Ankle Surgery Podiatrist",
          "LicenseNumber": null,
          "LicenseNumberStateCode": null,
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "261QR1300X",
          "TaxonomyName": "Rural Health Clinic/Center",
          "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."
        },
        {
          "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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