NPI Code Detail JSON Logo

1619428166 NPI number — BENJAMIN ANDREWS DC

NPI Number: 1619428166
Health Care Provider/Practitioner: BENJAMIN ANDREWS DC

Information about “1619428166” NPI (BENJAMIN ANDREWS DC) exists in 1619428166 in HTML format HTML  |  1619428166 in plain Text format TXT  |  1619428166 in PDF (Portable Document Format) PDF  |  1619428166 in an XML format XML  formats.

NPI Number : 1619428166 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1619428166",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "N",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "ANDREWS",
    "FirstName": "BENJAMIN",
    "MiddleName": null,
    "NamePrefix": null,
    "NameSuffix": null,
    "Credential": "DC",
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": null,
    "OtherFirstName": null,
    "OtherMiddleName": null,
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": null,
    "FirstLineMailingAddress": "9904 WINDING RIDGE DR",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "DALLAS",
    "MailingAddressStateName": "TX",
    "MailingAddressPostalCode": "75238-1460",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "907-538-7649",
    "MailingAddressFaxNumber": null,
    "FirstLinePracticeLocationAddress": "3248 NW GRAND BLVD",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "OKLAHOMA CITY",
    "PracticeLocationAddressStateName": "OK",
    "PracticeLocationAddressPostalCode": "73116-3019",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "907-538-7649",
    "PracticeLocationAddressFaxNumber": null,
    "EnumerationDate": "10/19/2016",
    "LastUpdateDate": "01/07/2025",
    "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": "111N00000X",
          "TaxonomyName": "Chiropractor",
          "LicenseNumber": "114814",
          "LicenseNumberStateCode": "AL",
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "111NS0005X",
          "TaxonomyName": "Sports Physician Chiropractor",
          "LicenseNumber": "4351",
          "LicenseNumberStateCode": "OK",
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "111NS0005X",
          "TaxonomyName": "Sports Physician Chiropractor",
          "LicenseNumber": "15520",
          "LicenseNumberStateCode": "TX",
          "PrimaryTaxonomySwitch": "Y"
        }
      ]
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

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