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1811390750 NPI number — HEALTHSTAT WELLNESS , INC.

NPI Number: 1811390750
Health Care Provider/Practitioner: HEALTHSTAT WELLNESS , INC.

Information about “1811390750” NPI (HEALTHSTAT WELLNESS , INC.) exists in 1811390750 in HTML format HTML  |  1811390750 in plain Text format TXT  |  1811390750 in PDF (Portable Document Format) PDF  |  1811390750 in an XML format XML  formats.

NPI Number : 1811390750 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1811390750",
    "EntityType": "Organization",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": null,
    "IsOrgSubpart": "Y",
    "ParentOrgLBN": "HEALTHSTAT WELLNESS, INC.",
    "ParentOrgTIN": null,
    "OrgName": "HEALTHSTAT WELLNESS , INC.",
    "LastName": null,
    "FirstName": null,
    "MiddleName": null,
    "NamePrefix": null,
    "NameSuffix": null,
    "Credential": null,
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": "6",
    "OtherLastName": null,
    "OtherFirstName": null,
    "OtherMiddleName": null,
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": null,
    "FirstLineMailingAddress": "10 W MARKET ST STE 2900",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "INDIANAPOLIS",
    "MailingAddressStateName": "IN",
    "MailingAddressPostalCode": "46204-2964",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": null,
    "MailingAddressFaxNumber": null,
    "FirstLinePracticeLocationAddress": "8606 GOVERNMENT DR STE 3",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "NEW PORT RICHEY",
    "PracticeLocationAddressStateName": "FL",
    "PracticeLocationAddressPostalCode": "34654-5510",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "727-816-1520",
    "PracticeLocationAddressFaxNumber": null,
    "EnumerationDate": "10/07/2014",
    "LastUpdateDate": "04/09/2025",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": null,
    "Gender": null,
    "AuthorizedOfficialLastName": "BARKER",
    "AuthorizedOfficialFirstName": "TOBIAS",
    "AuthorizedOfficialMiddleName": "D.",
    "AuthorizedOfficialTitle": "PRESIDENT",
    "AuthorizedOfficialNamePrefix": null,
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": "MD",
    "AuthorizedOfficialTelephoneNumber": "781-366-1655",
    "Taxonomies": {
      "Taxonomy": {
        "TaxonomyCode": "2083P0500X",
        "TaxonomyName": "Preventive Medicine/Occupational Environmental Medicine Physician",
        "LicenseNumber": null,
        "LicenseNumberStateCode": null,
        "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."
      }
    }
  }
}
                
            

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