{
"Npi": {
"NPI": "1689157166",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "HEALTHY LIVING DIABETES AND ENDOCRINOLOGY PLC",
"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": "908 W CHANDLER BLVD B-4",
"SecondLineMailingAddress": "BUILDING B, SUITE 4",
"MailingAddressCityName": "CHANDLER",
"MailingAddressStateName": "AZ",
"MailingAddressPostalCode": "85225-2548",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "480-269-6448",
"MailingAddressFaxNumber": "779-204-2331",
"FirstLinePracticeLocationAddress": "908 W CHANDLER BLVD B-4",
"SecondLinePracticeLocationAddress": "BUILDING B, SUITE 4",
"PracticeLocationAddressCityName": "CHANDLER",
"PracticeLocationAddressStateName": "AZ",
"PracticeLocationAddressPostalCode": "85225-2548",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "480-269-6448",
"PracticeLocationAddressFaxNumber": "779-204-2331",
"EnumerationDate": "09/11/2018",
"LastUpdateDate": "09/01/2022",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "TIRUMALASETTY",
"AuthorizedOfficialFirstName": "NAGA NALINI",
"AuthorizedOfficialMiddleName": null,
"AuthorizedOfficialTitle": "MEMBER/MANAGING EMPLOYEE",
"AuthorizedOfficialNamePrefix": "DR.",
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "MD, ECNU, FACE",
"AuthorizedOfficialTelephoneNumber": "480-269-6448",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "207RE0101X",
"TaxonomyName": "Endocrinology, Diabetes & Metabolism Physician",
"LicenseNumber": null,
"LicenseNumberStateCode": null,
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": {
"HealthcareProviderTaxonomyGroup": {
"HealthcareProviderTaxonomyGroupName": "193400000X SINGLE SPECIALTY GROUP",
"HealthcareProviderTaxonomyGroupDescription": "Single Specialty Group - A business group of one or more individual practitioners, all of who practice with the same area of specialization."
}
}
}
}