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1730912239 NPI number — MARY WHARRY PT

NPI Number: 1730912239
Health Care Provider/Practitioner: MARY WHARRY PT

Information about “1730912239” NPI (MARY WHARRY PT) exists in 1730912239 in HTML format HTML  |  1730912239 in plain Text format TXT  |  1730912239 in PDF (Portable Document Format) PDF  |  1730912239 in an XML format XML  formats.

NPI Number : 1730912239 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1730912239",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "N",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "WHARRY",
    "FirstName": "MARY",
    "MiddleName": null,
    "NamePrefix": null,
    "NameSuffix": null,
    "Credential": "PT",
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": "SODEN",
    "OtherFirstName": "MARY",
    "OtherMiddleName": null,
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": "1",
    "FirstLineMailingAddress": "PO BOX 5285",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "GRAND ISLAND",
    "MailingAddressStateName": "NE",
    "MailingAddressPostalCode": "68802-5285",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "308-675-1853",
    "MailingAddressFaxNumber": "308-210-4121",
    "FirstLinePracticeLocationAddress": "4001 O ST",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "LINCOLN",
    "PracticeLocationAddressStateName": "NE",
    "PracticeLocationAddressPostalCode": "68510-1755",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "402-817-0834",
    "PracticeLocationAddressFaxNumber": "402-817-0835",
    "EnumerationDate": "08/21/2024",
    "LastUpdateDate": "08/21/2024",
    "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": "225100000X",
        "TaxonomyName": "Physical Therapist",
        "LicenseNumber": "4694",
        "LicenseNumberStateCode": "NE",
        "PrimaryTaxonomySwitch": "Y"
      }
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

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