{
"Npi": {
"NPI": "1447483516",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "ONE LIFE CHIROPRACTIC",
"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": "317 HAPPY DAY BLVD",
"SecondLineMailingAddress": "SUITE 170",
"MailingAddressCityName": "CALDWELL",
"MailingAddressStateName": "ID",
"MailingAddressPostalCode": "83607-8115",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "208-459-6141",
"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "317 HAPPY DAY BLVD",
"SecondLinePracticeLocationAddress": "SUITE 170",
"PracticeLocationAddressCityName": "CALDWELL",
"PracticeLocationAddressStateName": "ID",
"PracticeLocationAddressPostalCode": "83607-8115",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "208-459-6141",
"PracticeLocationAddressFaxNumber": null,
"EnumerationDate": "08/24/2009",
"LastUpdateDate": "08/25/2009",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "HEIN",
"AuthorizedOfficialFirstName": "RYAN",
"AuthorizedOfficialMiddleName": "GIB",
"AuthorizedOfficialTitle": "DOCTOR OF CHIROPRACTIC",
"AuthorizedOfficialNamePrefix": "DR.",
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "D.C.",
"AuthorizedOfficialTelephoneNumber": "208-459-6141",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "111N00000X",
"TaxonomyName": "Chiropractor",
"LicenseNumber": "CHIA-1342",
"LicenseNumberStateCode": "ID",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": {
"HealthcareProviderTaxonomyGroup": {
"HealthcareProviderTaxonomyGroupName": "193400000X SINGLE SPECIALTY GROUP",
"HealthcareProviderTaxonomyGroupDescription": "Single Specialty Group - A business group of one or more individual practitioners, all of who practice with the same area of specialization."
}
}
}
}