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1811380199 NPI number — KEVIN PATRICK LORD ATC

NPI Number: 1811380199
Health Care Provider/Practitioner: KEVIN PATRICK LORD ATC

Information about “1811380199” NPI (KEVIN PATRICK LORD ATC) exists in 1811380199 in HTML format HTML  |  1811380199 in plain Text format TXT  |  1811380199 in PDF (Portable Document Format) PDF  |  1811380199 in an XML format XML  formats.

NPI Number : 1811380199 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1811380199",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "Y",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "LORD",
    "FirstName": "KEVIN",
    "MiddleName": "PATRICK",
    "NamePrefix": null,
    "NameSuffix": null,
    "Credential": "ATC",
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": null,
    "OtherFirstName": null,
    "OtherMiddleName": null,
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": null,
    "FirstLineMailingAddress": "5989 MERGENTHAL CT",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "WELDON SPRING",
    "MailingAddressStateName": "MO",
    "MailingAddressPostalCode": "63304-9129",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "760-681-8253",
    "MailingAddressFaxNumber": "636-246-0041",
    "FirstLinePracticeLocationAddress": "2885 LOKER AVE E",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "CARLSBAD",
    "PracticeLocationAddressStateName": "CA",
    "PracticeLocationAddressPostalCode": "92010-6626",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "760-681-8253",
    "PracticeLocationAddressFaxNumber": "636-246-0041",
    "EnumerationDate": "03/11/2015",
    "LastUpdateDate": "03/11/2015",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": "M",
    "Gender": "Male",
    "AuthorizedOfficialLastName": null,
    "AuthorizedOfficialFirstName": null,
    "AuthorizedOfficialMiddleName": null,
    "AuthorizedOfficialTitle": null,
    "AuthorizedOfficialNamePrefix": null,
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": null,
    "AuthorizedOfficialTelephoneNumber": null,
    "Taxonomies": {
      "Taxonomy": {
        "TaxonomyCode": "2255A2300X",
        "TaxonomyName": "Athletic Trainer",
        "LicenseNumber": "040502053",
        "LicenseNumberStateCode": "MO",
        "PrimaryTaxonomySwitch": "Y"
      }
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

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