NPI Code Detail JSON Logo

1467484980 NPI number — KANDICE JOETTE WOMMACK D.C.

NPI Number: 1467484980
Health Care Provider/Practitioner: KANDICE JOETTE WOMMACK D.C.

Information about “1467484980” NPI (KANDICE JOETTE WOMMACK D.C.) exists in 1467484980 in HTML format HTML  |  1467484980 in plain Text format TXT  |  1467484980 in PDF (Portable Document Format) PDF  |  1467484980 in an XML format XML  formats.

NPI Number : 1467484980 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1467484980",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "Y",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "WOMMACK",
    "FirstName": "KANDICE",
    "MiddleName": "JOETTE",
    "NamePrefix": "DR.",
    "NameSuffix": null,
    "Credential": "D.C.",
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": null,
    "OtherFirstName": null,
    "OtherMiddleName": null,
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": null,
    "FirstLineMailingAddress": "142 VINE ST",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "BENTON",
    "MailingAddressStateName": "KY",
    "MailingAddressPostalCode": "42025-7472",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "270-527-0000",
    "MailingAddressFaxNumber": "270-527-2121",
    "FirstLinePracticeLocationAddress": "142 VINE ST",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "BENTON",
    "PracticeLocationAddressStateName": "KY",
    "PracticeLocationAddressPostalCode": "42025-7472",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "270-527-0000",
    "PracticeLocationAddressFaxNumber": "270-527-2121",
    "EnumerationDate": "07/07/2006",
    "LastUpdateDate": "10/16/2017",
    "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": "111N00000X",
        "TaxonomyName": "Chiropractor",
        "LicenseNumber": "4556",
        "LicenseNumberStateCode": "KY",
        "PrimaryTaxonomySwitch": "Y"
      }
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

Copyright © 2007-2026 Data Labs Health. All rights reserved.