NPI Code Detail JSON Logo

1508794421 NPI number — SIGNATURE PHYSICAL THERAPY AND WELLNESS PLLC KIMBERLY SIPPLE DEMUN SOLE MBR

NPI Number: 1508794421
Health Care Provider/Practitioner: SIGNATURE PHYSICAL THERAPY AND WELLNESS PLLC KIMBERLY SIPPLE DEMUN SOLE MBR

Information about “1508794421” NPI (SIGNATURE PHYSICAL THERAPY AND WELLNESS PLLC KIMBERLY SIPPLE DEMUN SOLE MBR) exists in 1508794421 in HTML format HTML  |  1508794421 in plain Text format TXT  |  1508794421 in PDF (Portable Document Format) PDF  |  1508794421 in an XML format XML  formats.

NPI Number : 1508794421 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1508794421",
    "EntityType": "Organization",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": null,
    "IsOrgSubpart": "N",
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": "SIGNATURE PHYSICAL THERAPY AND WELLNESS PLLC KIMBERLY SIPPLE DEMUN SOLE MBR",
    "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": "5836 E IRISH PL",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "CENTENNIAL",
    "MailingAddressStateName": "CO",
    "MailingAddressPostalCode": "80112-6518",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "952-994-0178",
    "MailingAddressFaxNumber": null,
    "FirstLinePracticeLocationAddress": "5836 E IRISH PL",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "CENTENNIAL",
    "PracticeLocationAddressStateName": "CO",
    "PracticeLocationAddressPostalCode": "80112-6518",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "952-994-0178",
    "PracticeLocationAddressFaxNumber": null,
    "EnumerationDate": "05/11/2026",
    "LastUpdateDate": "05/11/2026",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": null,
    "Gender": null,
    "AuthorizedOfficialLastName": "DEMUN",
    "AuthorizedOfficialFirstName": "KIMBERLY",
    "AuthorizedOfficialMiddleName": "SIPPLE",
    "AuthorizedOfficialTitle": "OWNER",
    "AuthorizedOfficialNamePrefix": null,
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": "PT",
    "AuthorizedOfficialTelephoneNumber": "952-994-0178",
    "Taxonomies": {
      "Taxonomy": {
        "TaxonomyCode": "261QP2000X",
        "TaxonomyName": "Physical Therapy Clinic/Center",
        "LicenseNumber": null,
        "LicenseNumberStateCode": null,
        "PrimaryTaxonomySwitch": "Y"
      }
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

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