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1558299669 NPI number — PASSION DE'ERA BECKHAM I

NPI Number: 1558299669
Health Care Provider/Practitioner: PASSION DE'ERA BECKHAM I

Information about “1558299669” NPI (PASSION DE'ERA BECKHAM I) exists in 1558299669 in HTML format HTML  |  1558299669 in plain Text format TXT  |  1558299669 in PDF (Portable Document Format) PDF  |  1558299669 in an XML format XML  formats.

NPI Number : 1558299669 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1558299669",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "N",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "BECKHAM",
    "FirstName": "PASSION",
    "MiddleName": "DE'ERA",
    "NamePrefix": null,
    "NameSuffix": "I",
    "Credential": null,
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": null,
    "OtherFirstName": null,
    "OtherMiddleName": null,
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": null,
    "FirstLineMailingAddress": "6012 MAR DHEA LN APT 3305",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "CHARLOTTE",
    "MailingAddressStateName": "NC",
    "MailingAddressPostalCode": "28214-9475",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "704-954-9146",
    "MailingAddressFaxNumber": "704-954-9146",
    "FirstLinePracticeLocationAddress": "2730 ROZZELLES FERRY RD",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "CHARLOTTE",
    "PracticeLocationAddressStateName": "NC",
    "PracticeLocationAddressPostalCode": "28208-3233",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "980-380-8059",
    "PracticeLocationAddressFaxNumber": null,
    "EnumerationDate": "05/11/2026",
    "LastUpdateDate": "05/11/2026",
    "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": "106S00000X",
        "TaxonomyName": "Behavior Technician",
        "LicenseNumber": null,
        "LicenseNumberStateCode": "NC",
        "PrimaryTaxonomySwitch": "Y"
      }
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

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