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1497957708 NPI number — CYNTHIA ANNE MACKEY OT

NPI Number: 1497957708
Health Care Provider/Practitioner: CYNTHIA ANNE MACKEY OT

Information about “1497957708” NPI (CYNTHIA ANNE MACKEY OT) exists in 1497957708 in HTML format HTML  |  1497957708 in plain Text format TXT  |  1497957708 in PDF (Portable Document Format) PDF  |  1497957708 in an XML format XML  formats.

NPI Number : 1497957708 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1497957708",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "Y",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "MACKEY",
    "FirstName": "CYNTHIA",
    "MiddleName": "ANNE",
    "NamePrefix": "MS.",
    "NameSuffix": null,
    "Credential": "OT",
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": "BROWN",
    "OtherFirstName": "CYNTHIA",
    "OtherMiddleName": "ANNE",
    "OtherNamePrefix": "MRS.",
    "OtherNameSuffix": null,
    "OtherCredential": "OT",
    "OtherLastNameTypeCode": "1",
    "FirstLineMailingAddress": "15130 SUMMIT PLACE CIR",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "NAPLES",
    "MailingAddressStateName": "FL",
    "MailingAddressPostalCode": "34119-4107",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "239-248-7873",
    "MailingAddressFaxNumber": "239-348-7887",
    "FirstLinePracticeLocationAddress": "5860 GOLDEN GATE PKWY",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "NAPLES",
    "PracticeLocationAddressStateName": "FL",
    "PracticeLocationAddressPostalCode": "34116-7459",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "239-455-9525",
    "PracticeLocationAddressFaxNumber": "239-455-2844",
    "EnumerationDate": "05/31/2007",
    "LastUpdateDate": "07/09/2007",
    "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": "2251P0200X",
        "TaxonomyName": "Pediatric Physical Therapist",
        "LicenseNumber": "OT 11025",
        "LicenseNumberStateCode": "FL",
        "PrimaryTaxonomySwitch": "Y"
      }
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

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