NPI Code Detail JSON Logo

1538150719 NPI number — JANE PRINCE SMITH MSW

NPI Number: 1538150719
Health Care Provider/Practitioner: JANE PRINCE SMITH MSW

Information about “1538150719” NPI (JANE PRINCE SMITH MSW) exists in 1538150719 in HTML format HTML  |  1538150719 in plain Text format TXT  |  1538150719 in PDF (Portable Document Format) PDF  |  1538150719 in an XML format XML  formats.

NPI Number : 1538150719 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1538150719",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "N",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "SMITH",
    "FirstName": "JANE",
    "MiddleName": "PRINCE",
    "NamePrefix": "MS.",
    "NameSuffix": null,
    "Credential": "MSW",
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": null,
    "OtherFirstName": null,
    "OtherMiddleName": null,
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": null,
    "FirstLineMailingAddress": "PO BOX 2427",
    "SecondLineMailingAddress": "133 RINCON LOOP",
    "MailingAddressCityName": "TIJERAS",
    "MailingAddressStateName": "NM",
    "MailingAddressPostalCode": "87059-2427",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "505-186-1319",
    "MailingAddressFaxNumber": null,
    "FirstLinePracticeLocationAddress": "2600 MARBLE AVE NE",
    "SecondLinePracticeLocationAddress": "BLDG 2",
    "PracticeLocationAddressCityName": "ALBUQUERQUE",
    "PracticeLocationAddressStateName": "NM",
    "PracticeLocationAddressPostalCode": "87106-2058",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "505-220-7880",
    "PracticeLocationAddressFaxNumber": "505-288-3573",
    "EnumerationDate": "11/04/2005",
    "LastUpdateDate": "06/19/2012",
    "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": "1041C0700X",
        "TaxonomyName": "Clinical Social Worker",
        "LicenseNumber": "I 2539",
        "LicenseNumberStateCode": "NM",
        "PrimaryTaxonomySwitch": "Y"
      }
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

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