{
"Npi": {
"NPI": "1669836227",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "ONEOME HOLDINGS LLC",
"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": "PO BOX 856019",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "MINNEAPOLIS",
"MailingAddressStateName": "MN",
"MailingAddressPostalCode": "55485-6019",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "844-663-6635",
"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "807 BROADWAY ST NE STE 100",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "MINNEAPOLIS",
"PracticeLocationAddressStateName": "MN",
"PracticeLocationAddressPostalCode": "55413-4401",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "844-663-6635",
"PracticeLocationAddressFaxNumber": "833-962-6158",
"EnumerationDate": "04/11/2016",
"LastUpdateDate": "05/05/2023",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "MCINTYRE",
"AuthorizedOfficialFirstName": "PATRICK",
"AuthorizedOfficialMiddleName": "ALAN",
"AuthorizedOfficialTitle": "CEO",
"AuthorizedOfficialNamePrefix": null,
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": null,
"AuthorizedOfficialTelephoneNumber": "844-663-6635",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "291U00000X",
"TaxonomyName": "Clinical Medical Laboratory",
"LicenseNumber": "24D2109855",
"LicenseNumberStateCode": "MN",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}