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1740235720 NPI number — CAROLYN OATES BALLANTINE M.D.

NPI Number: 1740235720
Health Care Provider/Practitioner: CAROLYN OATES BALLANTINE M.D.

Information about “1740235720” NPI (CAROLYN OATES BALLANTINE M.D.) exists in 1740235720 in HTML format HTML  |  1740235720 in plain Text format TXT  |  1740235720 in PDF (Portable Document Format) PDF  |  1740235720 in an XML format XML  formats.

NPI Number : 1740235720 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1740235720",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "N",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "BALLANTINE",
    "FirstName": "CAROLYN",
    "MiddleName": "OATES",
    "NamePrefix": "DR.",
    "NameSuffix": null,
    "Credential": "M.D.",
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": null,
    "OtherFirstName": null,
    "OtherMiddleName": null,
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": null,
    "FirstLineMailingAddress": "8804 WELLSLEY WAY",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "RALEIGH",
    "MailingAddressStateName": "NC",
    "MailingAddressPostalCode": "27613-1358",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "919-593-5548",
    "MailingAddressFaxNumber": "919-929-8900",
    "FirstLinePracticeLocationAddress": "508 FULTON ST",
    "SecondLinePracticeLocationAddress": "DURHAM VAMC, MAIL CODE 116-A",
    "PracticeLocationAddressCityName": "DURHAM",
    "PracticeLocationAddressStateName": "NC",
    "PracticeLocationAddressPostalCode": "27705-3875",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "919-212-3011",
    "PracticeLocationAddressFaxNumber": "919-255-1540",
    "EnumerationDate": "05/24/2006",
    "LastUpdateDate": "06/06/2008",
    "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": "2084P0800X",
        "TaxonomyName": "Psychiatry Physician",
        "LicenseNumber": "200201134",
        "LicenseNumberStateCode": "NC",
        "PrimaryTaxonomySwitch": "Y"
      }
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

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