{
"Npi": {
"NPI": "1598612095",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "LUMINA IOWA PSYCHIATRY PROFESSIONAL CORPORATION",
"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": "3113 NW 27TH CIR",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "ANKENY",
"MailingAddressStateName": "IA",
"MailingAddressPostalCode": "50023-2690",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "515-336-2164",
"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "3113 NW 27TH CIR",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "ANKENY",
"PracticeLocationAddressStateName": "IA",
"PracticeLocationAddressPostalCode": "50023-2690",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "515-336-2164",
"PracticeLocationAddressFaxNumber": null,
"EnumerationDate": "03/13/2026",
"LastUpdateDate": "03/13/2026",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "TANDIA",
"AuthorizedOfficialFirstName": "HERMINA",
"AuthorizedOfficialMiddleName": null,
"AuthorizedOfficialTitle": "OWNER",
"AuthorizedOfficialNamePrefix": "DR.",
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "DNP-PMHNP-BC,ARNP",
"AuthorizedOfficialTelephoneNumber": "515-336-2164",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "261QM0850X",
"TaxonomyName": "Adult Mental Health Clinic/Center",
"LicenseNumber": null,
"LicenseNumberStateCode": null,
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}