{
"Npi": {
"NPI": "1588891279",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "Y",
"ParentOrgLBN": "NEWPORT ACUPUNCTURE & HERBAL MEDICINE, INC.",
"ParentOrgTIN": null,
"OrgName": "NEWPORT ACUPUNCTURE & HERBAL MEDICINE, INC.",
"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": "850 AQUIDNECK AVE",
"SecondLineMailingAddress": "A3",
"MailingAddressCityName": "MIDDLETOWN",
"MailingAddressStateName": "RI",
"MailingAddressPostalCode": "02842-7244",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "401-849-0514",
"MailingAddressFaxNumber": "401-324-6858",
"FirstLinePracticeLocationAddress": "850 AQUIDNECK AVE",
"SecondLinePracticeLocationAddress": "A3",
"PracticeLocationAddressCityName": "MIDDLETOWN",
"PracticeLocationAddressStateName": "RI",
"PracticeLocationAddressPostalCode": "02842-7244",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "401-849-0514",
"PracticeLocationAddressFaxNumber": "401-324-6858",
"EnumerationDate": "06/19/2009",
"LastUpdateDate": "06/19/2009",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "BOCK",
"AuthorizedOfficialFirstName": "SETH",
"AuthorizedOfficialMiddleName": "H",
"AuthorizedOfficialTitle": "CO-OWNER",
"AuthorizedOfficialNamePrefix": "DR.",
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "D.A.",
"AuthorizedOfficialTelephoneNumber": "401-849-0514",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "171100000X",
"TaxonomyName": "Acupuncturist",
"LicenseNumber": "DA 00180",
"LicenseNumberStateCode": "RI",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": {
"HealthcareProviderTaxonomyGroup": {
"HealthcareProviderTaxonomyGroupName": "193400000X MULTIPLE 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."
}
}
}
}