NPI Code Detail JSON Logo

1508708652 NPI number — NEW CHANGES LLC

NPI Number: 1508708652
Health Care Provider/Practitioner: NEW CHANGES LLC

Information about “1508708652” NPI (NEW CHANGES LLC) exists in 1508708652 in HTML format HTML  |  1508708652 in plain Text format TXT  |  1508708652 in PDF (Portable Document Format) PDF  |  1508708652 in an XML format XML  formats.

NPI Number : 1508708652 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1508708652",
    "EntityType": "Organization",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": null,
    "IsOrgSubpart": "N",
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": "NEW CHANGES 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": "1406B CRAIN HWY S STE 304",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "GLEN BURNIE",
    "MailingAddressStateName": "MD",
    "MailingAddressPostalCode": "21061-4094",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "301-804-0344",
    "MailingAddressFaxNumber": null,
    "FirstLinePracticeLocationAddress": "1406B CRAIN HWY S STE 304",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "GLEN BURNIE",
    "PracticeLocationAddressStateName": "MD",
    "PracticeLocationAddressPostalCode": "21061-4094",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "301-804-0344",
    "PracticeLocationAddressFaxNumber": null,
    "EnumerationDate": "04/07/2026",
    "LastUpdateDate": "04/07/2026",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": null,
    "Gender": null,
    "AuthorizedOfficialLastName": "MARTIN",
    "AuthorizedOfficialFirstName": "SHANNON",
    "AuthorizedOfficialMiddleName": null,
    "AuthorizedOfficialTitle": "OWNER",
    "AuthorizedOfficialNamePrefix": null,
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": "CRNP",
    "AuthorizedOfficialTelephoneNumber": "301-804-0344",
    "Taxonomies": {
      "Taxonomy": {
        "TaxonomyCode": "363LF0000X",
        "TaxonomyName": "Family Nurse Practitioner",
        "LicenseNumber": null,
        "LicenseNumberStateCode": null,
        "PrimaryTaxonomySwitch": "Y"
      }
    },
    "HealthcareProviderTaxonomyGroups": {
      "HealthcareProviderTaxonomyGroup": {
        "HealthcareProviderTaxonomyGroupName": "193200000X MULTI-SPECIALTY GROUP",
        "HealthcareProviderTaxonomyGroupDescription": "Multi-Specialty Group - A business group of one or more individual practitioners, who practice with different areas of specialization."
      }
    }
  }
}
                
            

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