{
"Npi": {
"NPI": "1790838126",
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"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "GREAT FALLS CHIROPRACTIC CLINIC, P.L.L.C",
"LastName": null,
"FirstName": null,
"MiddleName": null,
"NamePrefix": null,
"NameSuffix": null,
"Credential": null,
"OtherOrgName": null,
"OtherOrgNameTypeCode": null,
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"OtherFirstName": null,
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"OtherNameSuffix": null,
"OtherCredential": null,
"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "400 13TH AVE S",
"SecondLineMailingAddress": "SUITE 104",
"MailingAddressCityName": "GREAT FALLS",
"MailingAddressStateName": "MT",
"MailingAddressPostalCode": "59405-4300",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "406-727-1660",
"MailingAddressFaxNumber": "406-452-9094",
"FirstLinePracticeLocationAddress": "400 13TH AVE S",
"SecondLinePracticeLocationAddress": "SUITE 104",
"PracticeLocationAddressCityName": "GREAT FALLS",
"PracticeLocationAddressStateName": "MT",
"PracticeLocationAddressPostalCode": "59405-4300",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "406-727-1660",
"PracticeLocationAddressFaxNumber": "406-452-9094",
"EnumerationDate": "01/19/2007",
"LastUpdateDate": "02/08/2011",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "STOEBE",
"AuthorizedOfficialFirstName": "MARK",
"AuthorizedOfficialMiddleName": "T",
"AuthorizedOfficialTitle": "OWNER",
"AuthorizedOfficialNamePrefix": "DR.",
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "D.C.",
"AuthorizedOfficialTelephoneNumber": "406-727-1660",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "111NX0800X",
"TaxonomyName": "Orthopedic Chiropractor",
"LicenseNumber": "473",
"LicenseNumberStateCode": "MT",
"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."
}
}
}
}