{
"Npi": {
"NPI": "1679438733",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "GOLDEN DOOR 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": "33104 BRIERWOOD AVE",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "SEWARD",
"MailingAddressStateName": "AK",
"MailingAddressPostalCode": "99664-9613",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "907-599-0534",
"MailingAddressFaxNumber": "907-531-7339",
"FirstLinePracticeLocationAddress": "500 ADAMS ST STE 200",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "SEWARD",
"PracticeLocationAddressStateName": "AK",
"PracticeLocationAddressPostalCode": "99664-0640",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "907-599-0534",
"PracticeLocationAddressFaxNumber": "907-531-7339",
"EnumerationDate": "12/22/2025",
"LastUpdateDate": "12/22/2025",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "DICKINSON",
"AuthorizedOfficialFirstName": "LAVINA",
"AuthorizedOfficialMiddleName": null,
"AuthorizedOfficialTitle": "PARTNER",
"AuthorizedOfficialNamePrefix": null,
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "LMT",
"AuthorizedOfficialTelephoneNumber": "907-599-0534",
"Taxonomies": {
"Taxonomy": [
{
"TaxonomyCode": "163WI0500X",
"TaxonomyName": "Infusion Therapy Registered Nurse",
"LicenseNumber": null,
"LicenseNumberStateCode": null,
"PrimaryTaxonomySwitch": "N"
},
{
"TaxonomyCode": "208100000X",
"TaxonomyName": "Physical Medicine & Rehabilitation Physician",
"LicenseNumber": null,
"LicenseNumberStateCode": null,
"PrimaryTaxonomySwitch": "N"
},
{
"TaxonomyCode": "225700000X",
"TaxonomyName": "Massage Therapist",
"LicenseNumber": null,
"LicenseNumberStateCode": null,
"PrimaryTaxonomySwitch": "N"
},
{
"TaxonomyCode": "171100000X",
"TaxonomyName": "Acupuncturist",
"LicenseNumber": null,
"LicenseNumberStateCode": null,
"PrimaryTaxonomySwitch": "Y"
}
]
},
"HealthcareProviderTaxonomyGroups": {
"HealthcareProviderTaxonomyGroup": [
{
"HealthcareProviderTaxonomyGroupName": "193200000X MULTI-SPECIALTY GROUP",
"HealthcareProviderTaxonomyGroupDescription": "Multi-Specialty Group - A business group of one or more individual practitioners, who practice with different areas of specialization."
},
{
"HealthcareProviderTaxonomyGroupName": "193200000X MULTI-SPECIALTY GROUP",
"HealthcareProviderTaxonomyGroupDescription": "Multi-Specialty Group - A business group of one or more individual practitioners, who practice with different areas of specialization."
},
{
"HealthcareProviderTaxonomyGroupName": "193200000X MULTI-SPECIALTY GROUP",
"HealthcareProviderTaxonomyGroupDescription": "Multi-Specialty Group - A business group of one or more individual practitioners, who practice with different areas of specialization."
},
{
"HealthcareProviderTaxonomyGroupName": "193200000X MULTI-SPECIALTY GROUP",
"HealthcareProviderTaxonomyGroupDescription": "Multi-Specialty Group - A business group of one or more individual practitioners, who practice with different areas of specialization."
}
]
}
}
}