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1558030890 NPI number — LINDSEY BROOKE FORD LAT, ATC, MBA

NPI Number: 1558030890
Health Care Provider/Practitioner: LINDSEY BROOKE FORD LAT, ATC, MBA

Information about “1558030890” NPI (LINDSEY BROOKE FORD LAT, ATC, MBA) exists in 1558030890 in HTML format HTML  |  1558030890 in plain Text format TXT  |  1558030890 in PDF (Portable Document Format) PDF  |  1558030890 in an XML format XML  formats.

NPI Number : 1558030890 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1558030890",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "Y",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "FORD",
    "FirstName": "LINDSEY",
    "MiddleName": "BROOKE",
    "NamePrefix": "MISS",
    "NameSuffix": null,
    "Credential": "LAT, ATC, MBA",
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": null,
    "OtherFirstName": null,
    "OtherMiddleName": null,
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": null,
    "FirstLineMailingAddress": "742 MIDDLE CREEK RD",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "SEVIERVILLE",
    "MailingAddressStateName": "TN",
    "MailingAddressPostalCode": "37862-5019",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": null,
    "MailingAddressFaxNumber": null,
    "FirstLinePracticeLocationAddress": "742 MIDDLE CREEK RD",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "SEVIERVILLE",
    "PracticeLocationAddressStateName": "TN",
    "PracticeLocationAddressPostalCode": "37862-5019",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "865-446-7000",
    "PracticeLocationAddressFaxNumber": null,
    "EnumerationDate": "09/09/2021",
    "LastUpdateDate": "09/09/2021",
    "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": "2255A2300X",
        "TaxonomyName": "Athletic Trainer",
        "LicenseNumber": "2773",
        "LicenseNumberStateCode": "TN",
        "PrimaryTaxonomySwitch": "Y"
      }
    },
    "HealthcareProviderTaxonomyGroups": {
      "HealthcareProviderTaxonomyGroup": {
        "HealthcareProviderTaxonomyGroupName": "193400000X 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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