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1629846886 NPI number — SHIAN N HANKS LAT, ATC

NPI Number: 1629846886
Health Care Provider/Practitioner: SHIAN N HANKS LAT, ATC

Information about “1629846886” NPI (SHIAN N HANKS LAT, ATC) exists in 1629846886 in HTML format HTML  |  1629846886 in plain Text format TXT  |  1629846886 in PDF (Portable Document Format) PDF  |  1629846886 in an XML format XML  formats.

NPI Number : 1629846886 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1629846886",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "N",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "HANKS",
    "FirstName": "SHIAN",
    "MiddleName": "N",
    "NamePrefix": null,
    "NameSuffix": null,
    "Credential": "LAT, ATC",
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": null,
    "OtherFirstName": null,
    "OtherMiddleName": null,
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": null,
    "FirstLineMailingAddress": "175 INVERNESS DR W STE 200",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "ENGLEWOOD",
    "MailingAddressStateName": "CO",
    "MailingAddressPostalCode": "80112-5069",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "719-377-0068",
    "MailingAddressFaxNumber": null,
    "FirstLinePracticeLocationAddress": "175 INVERNESS DR W STE 200",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "ENGLEWOOD",
    "PracticeLocationAddressStateName": "CO",
    "PracticeLocationAddressPostalCode": "80112-5069",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "303-694-3333",
    "PracticeLocationAddressFaxNumber": null,
    "EnumerationDate": "12/18/2023",
    "LastUpdateDate": "10/17/2024",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": "F",
    "Gender": "Female",
    "AuthorizedOfficialLastName": null,
    "AuthorizedOfficialFirstName": null,
    "AuthorizedOfficialMiddleName": null,
    "AuthorizedOfficialTitle": null,
    "AuthorizedOfficialNamePrefix": null,
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": null,
    "AuthorizedOfficialTelephoneNumber": null,
    "Taxonomies": {
      "Taxonomy": [
        {
          "TaxonomyCode": "246ZC0007X",
          "TaxonomyName": "Surgical Assistant",
          "LicenseNumber": "SA.0003256",
          "LicenseNumberStateCode": "CO",
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "2255A2300X",
          "TaxonomyName": "Athletic Trainer",
          "LicenseNumber": "ATR-LAT-LIC-2548",
          "LicenseNumberStateCode": "MT",
          "PrimaryTaxonomySwitch": "Y"
        }
      ]
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

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