{
"Npi": {
"NPI": "1639518822",
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"EIN": null,
"IsSoleProprietor": "Y",
"IsOrgSubpart": null,
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": null,
"LastName": "SALDIVAR",
"FirstName": "RYAN",
"MiddleName": "M",
"NamePrefix": "MR.",
"NameSuffix": null,
"Credential": null,
"OtherOrgName": null,
"OtherOrgNameTypeCode": null,
"OtherLastName": "SALDIVAR",
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"OtherNameSuffix": null,
"OtherCredential": "LMT",
"OtherLastNameTypeCode": "2",
"FirstLineMailingAddress": "PO BOX 425",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "CERRILLOS",
"MailingAddressStateName": "NM",
"MailingAddressPostalCode": "87010-0425",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "505-489-0598",
"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "2884 HIGHWAY 14",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "MADRID",
"PracticeLocationAddressStateName": "NM",
"PracticeLocationAddressPostalCode": "87010",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "505-489-0598",
"PracticeLocationAddressFaxNumber": null,
"EnumerationDate": "06/20/2013",
"LastUpdateDate": "06/20/2013",
"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": "225700000X",
"TaxonomyName": "Massage Therapist",
"LicenseNumber": "225700000X - MASSAGE",
"LicenseNumberStateCode": "NM",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}