NPI Code Detail JSON Logo

1720501943 NPI number — BIG TREE PARTNERS LLC

NPI Number: 1720501943
Health Care Provider/Practitioner: BIG TREE PARTNERS LLC

Information about “1720501943” NPI (BIG TREE PARTNERS LLC) exists in 1720501943 in HTML format HTML  |  1720501943 in plain Text format TXT  |  1720501943 in PDF (Portable Document Format) PDF  |  1720501943 in an XML format XML  formats.

NPI Number : 1720501943 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1720501943",
    "EntityType": "Organization",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": null,
    "IsOrgSubpart": "N",
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": "BIG TREE PARTNERS LLC",
    "LastName": null,
    "FirstName": null,
    "MiddleName": null,
    "NamePrefix": null,
    "NameSuffix": null,
    "Credential": null,
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": "6",
    "OtherLastName": null,
    "OtherFirstName": null,
    "OtherMiddleName": null,
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": null,
    "FirstLineMailingAddress": "2814 INDIAN WELLS RD",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "ALAMOGORDO",
    "MailingAddressStateName": "NM",
    "MailingAddressPostalCode": "88310-3861",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": null,
    "MailingAddressFaxNumber": null,
    "FirstLinePracticeLocationAddress": "2814 INDIAN WELLS RD",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "ALAMOGORDO",
    "PracticeLocationAddressStateName": "NM",
    "PracticeLocationAddressPostalCode": "88310-3861",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "575-415-1927",
    "PracticeLocationAddressFaxNumber": null,
    "EnumerationDate": "07/19/2017",
    "LastUpdateDate": "01/29/2021",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": null,
    "Gender": null,
    "AuthorizedOfficialLastName": "WILTSHIRE",
    "AuthorizedOfficialFirstName": "ROBERT",
    "AuthorizedOfficialMiddleName": "C",
    "AuthorizedOfficialTitle": "PARTNER/MANAGER",
    "AuthorizedOfficialNamePrefix": "MR.",
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": null,
    "AuthorizedOfficialTelephoneNumber": "919-349-6300",
    "Taxonomies": {
      "Taxonomy": [
        {
          "TaxonomyCode": "207K00000X",
          "TaxonomyName": "Allergy & Immunology Physician",
          "LicenseNumber": null,
          "LicenseNumberStateCode": null,
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "207N00000X",
          "TaxonomyName": "Dermatology Physician",
          "LicenseNumber": null,
          "LicenseNumberStateCode": null,
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "363LF0000X",
          "TaxonomyName": "Family Nurse Practitioner",
          "LicenseNumber": "CNP-01499",
          "LicenseNumberStateCode": "NM",
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "207Q00000X",
          "TaxonomyName": "Family Medicine Physician",
          "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": "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."
        },
        {
          "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."
        }
      ]
    }
  }
}
                
            

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