NPI Code Detail JSON Logo

1619206513 NPI number — PROFESSIONAL PEER SERVICES

NPI Number: 1619206513
Health Care Provider/Practitioner: PROFESSIONAL PEER SERVICES

Information about “1619206513” NPI (PROFESSIONAL PEER SERVICES) exists in 1619206513 in HTML format HTML  |  1619206513 in plain Text format TXT  |  1619206513 in PDF (Portable Document Format) PDF  |  1619206513 in an XML format XML  formats.

NPI Number : 1619206513 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1619206513",
    "EntityType": "Organization",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": null,
    "IsOrgSubpart": "N",
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": "PROFESSIONAL PEER SERVICES",
    "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": "316 S MARTIN L KING BLVD",
    "SecondLineMailingAddress": "# 2",
    "MailingAddressCityName": "LANSING",
    "MailingAddressStateName": "MI",
    "MailingAddressPostalCode": "48915",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": null,
    "MailingAddressFaxNumber": null,
    "FirstLinePracticeLocationAddress": "316 S MARTIN L KING BLVD",
    "SecondLinePracticeLocationAddress": "# 2",
    "PracticeLocationAddressCityName": "LANSING",
    "PracticeLocationAddressStateName": "MI",
    "PracticeLocationAddressPostalCode": "48915",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "517-316-9033",
    "PracticeLocationAddressFaxNumber": null,
    "EnumerationDate": "12/24/2009",
    "LastUpdateDate": "12/24/2009",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": null,
    "Gender": null,
    "AuthorizedOfficialLastName": "BIDIGARE",
    "AuthorizedOfficialFirstName": "MICHELLE",
    "AuthorizedOfficialMiddleName": null,
    "AuthorizedOfficialTitle": "CHIEF OPERATIONS OFFICER",
    "AuthorizedOfficialNamePrefix": null,
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": "C.P.S.S.",
    "AuthorizedOfficialTelephoneNumber": "517-316-9033",
    "Taxonomies": {
      "Taxonomy": {
        "TaxonomyCode": "251S00000X",
        "TaxonomyName": "Community/Behavioral Health Agency",
        "LicenseNumber": null,
        "LicenseNumberStateCode": null,
        "PrimaryTaxonomySwitch": "Y"
      }
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

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