NPI Code Detail JSON Logo

1578750568 NPI number — ASHLEIGH LEWIS JOHNSON PAC

NPI Number: 1578750568
Health Care Provider/Practitioner: ASHLEIGH LEWIS JOHNSON PAC

Information about “1578750568” NPI (ASHLEIGH LEWIS JOHNSON PAC) exists in 1578750568 in HTML format HTML  |  1578750568 in plain Text format TXT  |  1578750568 in PDF (Portable Document Format) PDF  |  1578750568 in an XML format XML  formats.

NPI Number : 1578750568 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1578750568",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "N",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "JOHNSON",
    "FirstName": "ASHLEIGH",
    "MiddleName": "LEWIS",
    "NamePrefix": null,
    "NameSuffix": null,
    "Credential": "PAC",
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": "RENTZ",
    "OtherFirstName": "ASHLEIGH",
    "OtherMiddleName": "LEWIS",
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": "PA-C",
    "OtherLastNameTypeCode": "1",
    "FirstLineMailingAddress": "823 S 1ST ST",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "JESUP",
    "MailingAddressStateName": "GA",
    "MailingAddressPostalCode": "31545-0209",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "912-456-3755",
    "MailingAddressFaxNumber": "912-303-7727",
    "FirstLinePracticeLocationAddress": "823 S 1ST ST",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "JESUP",
    "PracticeLocationAddressStateName": "GA",
    "PracticeLocationAddressPostalCode": "31545-0209",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "912-456-3755",
    "PracticeLocationAddressFaxNumber": "912-303-7727",
    "EnumerationDate": "10/03/2007",
    "LastUpdateDate": "04/19/2024",
    "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": "363A00000X",
          "TaxonomyName": "Physician Assistant",
          "LicenseNumber": "5151",
          "LicenseNumberStateCode": "GA",
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "363A00000X",
          "TaxonomyName": "Physician Assistant",
          "LicenseNumber": "005151",
          "LicenseNumberStateCode": "GA",
          "PrimaryTaxonomySwitch": "Y"
        }
      ]
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

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