{
"Npi": {
"NPI": "1811292436",
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"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "CLEARWATER SPORTS & WELLNESS PA",
"LastName": null,
"FirstName": null,
"MiddleName": null,
"NamePrefix": null,
"NameSuffix": null,
"Credential": null,
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"OtherOrgNameTypeCode": null,
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"OtherCredential": null,
"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "2555 ENTERPRISE RD",
"SecondLineMailingAddress": "STE 5",
"MailingAddressCityName": "CLEARWATER",
"MailingAddressStateName": "FL",
"MailingAddressPostalCode": "33763-1104",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "727-669-3900",
"MailingAddressFaxNumber": "727-669-3998",
"FirstLinePracticeLocationAddress": "2555 ENTERPRISE RD",
"SecondLinePracticeLocationAddress": "STE 5",
"PracticeLocationAddressCityName": "CLEARWATER",
"PracticeLocationAddressStateName": "FL",
"PracticeLocationAddressPostalCode": "33763-1104",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "727-669-3900",
"PracticeLocationAddressFaxNumber": "727-669-3998",
"EnumerationDate": "01/12/2011",
"LastUpdateDate": "01/12/2011",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "SESSA",
"AuthorizedOfficialFirstName": "FRANK",
"AuthorizedOfficialMiddleName": "VINCENT",
"AuthorizedOfficialTitle": "OWNER",
"AuthorizedOfficialNamePrefix": "DR.",
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "D.C.",
"AuthorizedOfficialTelephoneNumber": "727-669-3900",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "111N00000X",
"TaxonomyName": "Chiropractor",
"LicenseNumber": "CH9211",
"LicenseNumberStateCode": "FL",
"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."
}
}
}
}