1609933886 NPI number — ERIK W BRIZZEE AU.D., CCC-A

NPI Number: 1609933886
Health Care Provider/Practitioner: ERIK W BRIZZEE AU.D., CCC-A

NPI Number : 1609933886 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1609933886",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "N",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "BRIZZEE",
    "FirstName": "ERIK",
    "MiddleName": "W",
    "NamePrefix": null,
    "NameSuffix": null,
    "Credential": "AU.D., CCC-A",
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": null,
    "OtherFirstName": null,
    "OtherMiddleName": null,
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": null,
    "FirstLineMailingAddress": "4510 E BANNER GATEWAY DR APT 1007",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "MESA",
    "MailingAddressStateName": "AZ",
    "MailingAddressPostalCode": "85206-4749",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "857-272-2872",
    "MailingAddressFaxNumber": null,
    "FirstLinePracticeLocationAddress": "11000 N SCOTTSDALE RD STE 165",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "SCOTTSDALE",
    "PracticeLocationAddressStateName": "AZ",
    "PracticeLocationAddressPostalCode": "85254-5104",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "602-910-2673",
    "PracticeLocationAddressFaxNumber": null,
    "EnumerationDate": "01/03/2007",
    "LastUpdateDate": "01/11/2024",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": "M",
    "Gender": "Male",
    "AuthorizedOfficialLastName": null,
    "AuthorizedOfficialFirstName": null,
    "AuthorizedOfficialMiddleName": null,
    "AuthorizedOfficialTitle": null,
    "AuthorizedOfficialNamePrefix": null,
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": null,
    "AuthorizedOfficialTelephoneNumber": null,
    "Taxonomies": {
      "Taxonomy": [
        {
          "TaxonomyCode": "231H00000X",
          "TaxonomyName": "Audiologist",
          "LicenseNumber": "836",
          "LicenseNumberStateCode": "MA",
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "231H00000X",
          "TaxonomyName": "Audiologist",
          "LicenseNumber": "DA11717",
          "LicenseNumberStateCode": "AZ",
          "PrimaryTaxonomySwitch": "Y"
        }
      ]
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}