{
"Npi": {
"NPI": "1578872024",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "PAPE CHIROPRACTIC & WELLNESS CENTER LLC",
"LastName": null,
"FirstName": null,
"MiddleName": null,
"NamePrefix": null,
"NameSuffix": null,
"Credential": null,
"OtherOrgName": null,
"OtherOrgNameTypeCode": null,
"OtherLastName": null,
"OtherFirstName": null,
"OtherMiddleName": null,
"OtherNamePrefix": null,
"OtherNameSuffix": null,
"OtherCredential": null,
"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "PO BOX 944",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "EAST LYME",
"MailingAddressStateName": "CT",
"MailingAddressPostalCode": "06333-0944",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "860-739-3600",
"MailingAddressFaxNumber": "860-739-3400",
"FirstLinePracticeLocationAddress": "11 FREEDOM WAY",
"SecondLinePracticeLocationAddress": "UNIT B-01",
"PracticeLocationAddressCityName": "NIANTIC",
"PracticeLocationAddressStateName": "CT",
"PracticeLocationAddressPostalCode": "06357-1041",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "860-739-3600",
"PracticeLocationAddressFaxNumber": "860-739-3400",
"EnumerationDate": "10/01/2010",
"LastUpdateDate": "02/12/2013",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "PAPE",
"AuthorizedOfficialFirstName": "TIANNE",
"AuthorizedOfficialMiddleName": "A",
"AuthorizedOfficialTitle": "OWNER",
"AuthorizedOfficialNamePrefix": "DR.",
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "D.C.",
"AuthorizedOfficialTelephoneNumber": "860-739-3600",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "111NN1001X",
"TaxonomyName": "Nutrition Chiropractor",
"LicenseNumber": "001857",
"LicenseNumberStateCode": "CT",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": {
"HealthcareProviderTaxonomyGroup": {
"HealthcareProviderTaxonomyGroupName": "193200000X MULTI-SPECIALTY GROUP",
"HealthcareProviderTaxonomyGroupDescription": "Multi-Specialty Group - A business group of one or more individual practitioners, who practice with different areas of specialization."
}
}
}
}