NPI Code Detail JSON Logo

1528504065 NPI number — NSMD MEDICAL PLLC

NPI Number: 1528504065
Health Care Provider/Practitioner: NSMD MEDICAL PLLC

Information about “1528504065” NPI (NSMD MEDICAL PLLC) exists in 1528504065 in HTML format HTML  |  1528504065 in plain Text format TXT  |  1528504065 in PDF (Portable Document Format) PDF  |  1528504065 in an XML format XML  formats.

NPI Number : 1528504065 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1528504065",
    "EntityType": "Organization",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": null,
    "IsOrgSubpart": "N",
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": "NSMD MEDICAL PLLC",
    "LastName": null,
    "FirstName": null,
    "MiddleName": null,
    "NamePrefix": null,
    "NameSuffix": null,
    "Credential": null,
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": "6",
    "OtherLastName": null,
    "OtherFirstName": null,
    "OtherMiddleName": null,
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": null,
    "FirstLineMailingAddress": "PO BOX 4467",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "MIDLAND",
    "MailingAddressStateName": "TX",
    "MailingAddressPostalCode": "79704-4467",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "432-704-5663",
    "MailingAddressFaxNumber": "432-704-5660",
    "FirstLinePracticeLocationAddress": "4400 N MIDLAND DR",
    "SecondLinePracticeLocationAddress": "406B",
    "PracticeLocationAddressCityName": "MIDLAND",
    "PracticeLocationAddressStateName": "TX",
    "PracticeLocationAddressPostalCode": "79707-3385",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "432-704-5663",
    "PracticeLocationAddressFaxNumber": "432-704-5660",
    "EnumerationDate": "01/09/2017",
    "LastUpdateDate": "01/09/2017",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": null,
    "Gender": null,
    "AuthorizedOfficialLastName": "WYNNE",
    "AuthorizedOfficialFirstName": "CANDACE",
    "AuthorizedOfficialMiddleName": "D",
    "AuthorizedOfficialTitle": "BILLING",
    "AuthorizedOfficialNamePrefix": null,
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": null,
    "AuthorizedOfficialTelephoneNumber": "432-704-5663",
    "Taxonomies": {
      "Taxonomy": [
        {
          "TaxonomyCode": "207Q00000X",
          "TaxonomyName": "Family Medicine Physician",
          "LicenseNumber": "AP121037",
          "LicenseNumberStateCode": "TX",
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "207Q00000X",
          "TaxonomyName": "Family Medicine Physician",
          "LicenseNumber": "AP128857",
          "LicenseNumberStateCode": "TX",
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "207Q00000X",
          "TaxonomyName": "Family Medicine Physician",
          "LicenseNumber": "Q7356",
          "LicenseNumberStateCode": "TX",
          "PrimaryTaxonomySwitch": "Y"
        }
      ]
    },
    "HealthcareProviderTaxonomyGroups": {
      "HealthcareProviderTaxonomyGroup": [
        {
          "HealthcareProviderTaxonomyGroupName": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
          "HealthcareProviderTaxonomyGroupDescription": "Single Specialty Group - A business group of one or more individual practitioners, all of who practice with the same area of specialization."
        },
        {
          "HealthcareProviderTaxonomyGroupName": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
          "HealthcareProviderTaxonomyGroupDescription": "Single Specialty Group - A business group of one or more individual practitioners, all of who practice with the same area of specialization."
        },
        {
          "HealthcareProviderTaxonomyGroupName": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
          "HealthcareProviderTaxonomyGroupDescription": "Single Specialty Group - A business group of one or more individual practitioners, all of who practice with the same area of specialization."
        }
      ]
    }
  }
}
                
            

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