NPI Code Detail JSON Logo

1467614503 NPI number — WINTER MARIE ACKERMAN MD

NPI Number: 1467614503
Health Care Provider/Practitioner: WINTER MARIE ACKERMAN MD

Information about “1467614503” NPI (WINTER MARIE ACKERMAN MD) exists in 1467614503 in HTML format HTML  |  1467614503 in plain Text format TXT  |  1467614503 in PDF (Portable Document Format) PDF  |  1467614503 in an XML format XML  formats.

NPI Number : 1467614503 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1467614503",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "N",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "ACKERMAN",
    "FirstName": "WINTER",
    "MiddleName": "MARIE",
    "NamePrefix": "DR.",
    "NameSuffix": null,
    "Credential": "MD",
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": "WILSON",
    "OtherFirstName": "WINTER",
    "OtherMiddleName": "MARIE",
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": "MD",
    "OtherLastNameTypeCode": "1",
    "FirstLineMailingAddress": "PO BOX 2168",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "FARGO",
    "MailingAddressStateName": "ND",
    "MailingAddressPostalCode": "58107-2168",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "701-234-2119",
    "MailingAddressFaxNumber": null,
    "FirstLinePracticeLocationAddress": "332 2ND AVE N",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "WAHPETON",
    "PracticeLocationAddressStateName": "ND",
    "PracticeLocationAddressPostalCode": "58075-4528",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "701-642-7000",
    "PracticeLocationAddressFaxNumber": "701-642-7055",
    "EnumerationDate": "06/30/2008",
    "LastUpdateDate": "12/19/2013",
    "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": "207Q00000X",
        "TaxonomyName": "Family Medicine Physician",
        "LicenseNumber": "11731",
        "LicenseNumberStateCode": "ND",
        "PrimaryTaxonomySwitch": "Y"
      }
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

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