NPI Code Detail JSON Logo

1700542313 NPI number — ALISHA I LEITH CRM

NPI Number: 1700542313
Health Care Provider/Practitioner: ALISHA I LEITH CRM

Information about “1700542313” NPI (ALISHA I LEITH CRM) exists in 1700542313 in HTML format HTML  |  1700542313 in plain Text format TXT  |  1700542313 in PDF (Portable Document Format) PDF  |  1700542313 in an XML format XML  formats.

NPI Number : 1700542313 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1700542313",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "Y",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "LEITH",
    "FirstName": "ALISHA",
    "MiddleName": "I",
    "NamePrefix": null,
    "NameSuffix": null,
    "Credential": "CRM",
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": "CORBIN",
    "OtherFirstName": "ALISHA",
    "OtherMiddleName": "I",
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": "1",
    "FirstLineMailingAddress": "130 S MAIN ST",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "PRINEVILLE",
    "MailingAddressStateName": "OR",
    "MailingAddressPostalCode": "97754-2744",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "541-350-9366",
    "MailingAddressFaxNumber": null,
    "FirstLinePracticeLocationAddress": "130 S MAIN ST",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "PRINEVILLE",
    "PracticeLocationAddressStateName": "OR",
    "PracticeLocationAddressPostalCode": "97754-2744",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "541-350-9366",
    "PracticeLocationAddressFaxNumber": null,
    "EnumerationDate": "11/09/2021",
    "LastUpdateDate": "11/09/2021",
    "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": "175T00000X",
        "TaxonomyName": "Peer Specialist",
        "LicenseNumber": "21-CRM-695",
        "LicenseNumberStateCode": "OR",
        "PrimaryTaxonomySwitch": "Y"
      }
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

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