{
"Npi": {
"NPI": "1578640975",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "BRANT T KOENIG 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": "800 W 18TH ST",
"SecondLineMailingAddress": "SUITE 120",
"MailingAddressCityName": "EDMOND",
"MailingAddressStateName": "OK",
"MailingAddressPostalCode": "73013-3758",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "405-286-0322",
"MailingAddressFaxNumber": "405-285-7034",
"FirstLinePracticeLocationAddress": "305 N BROADWAY",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "EDMOND",
"PracticeLocationAddressStateName": "OK",
"PracticeLocationAddressPostalCode": "73034-3681",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "405-348-5901",
"PracticeLocationAddressFaxNumber": "405-348-5923",
"EnumerationDate": "11/01/2006",
"LastUpdateDate": "02/05/2014",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "KOENIG",
"AuthorizedOfficialFirstName": "BRANT",
"AuthorizedOfficialMiddleName": "THOMAS",
"AuthorizedOfficialTitle": "OWNER",
"AuthorizedOfficialNamePrefix": "DR.",
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "D.C.",
"AuthorizedOfficialTelephoneNumber": "405-348-5901",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "111N00000X",
"TaxonomyName": "Chiropractor",
"LicenseNumber": "3800",
"LicenseNumberStateCode": "OK",
"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."
}
}
}
}