{
"Npi": {
"NPI": "1487183463",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "HEARTLAND CHIROPRACTIC & WELLNESS, LLC",
"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": "PO BOX 214",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "UNIONVILLE",
"MailingAddressStateName": "MO",
"MailingAddressPostalCode": "63565-0214",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "660-947-7325",
"MailingAddressFaxNumber": "660-947-7326",
"FirstLinePracticeLocationAddress": "1719 MAIN ST",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "UNIONVILLE",
"PracticeLocationAddressStateName": "MO",
"PracticeLocationAddressPostalCode": "63565-1661",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "660-947-7325",
"PracticeLocationAddressFaxNumber": "660-947-7326",
"EnumerationDate": "06/05/2017",
"LastUpdateDate": "05/28/2020",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "TRIPLETT",
"AuthorizedOfficialFirstName": "SARAH",
"AuthorizedOfficialMiddleName": "CHRISTINE",
"AuthorizedOfficialTitle": "DOCTOR OF CHIROPRACTIC/OWNER",
"AuthorizedOfficialNamePrefix": "MRS.",
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "DC",
"AuthorizedOfficialTelephoneNumber": "660-947-7325",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "261QP2300X",
"TaxonomyName": "Primary Care Clinic/Center",
"LicenseNumber": "2017001178",
"LicenseNumberStateCode": "MO",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}