NPI Code Detail JSON Logo

1821981291 NPI number — TINA MODUPE AMAECHI

NPI Number: 1821981291
Health Care Provider/Practitioner: TINA MODUPE AMAECHI

Information about “1821981291” NPI (TINA MODUPE AMAECHI) exists in 1821981291 in HTML format HTML  |  1821981291 in plain Text format TXT  |  1821981291 in PDF (Portable Document Format) PDF  |  1821981291 in an XML format XML  formats.

NPI Number : 1821981291 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1821981291",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "Y",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "AMAECHI",
    "FirstName": "TINA",
    "MiddleName": "MODUPE",
    "NamePrefix": null,
    "NameSuffix": null,
    "Credential": null,
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": null,
    "OtherFirstName": null,
    "OtherMiddleName": null,
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": null,
    "FirstLineMailingAddress": "16210 TRACEY LEE CT",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "OREGON CITY",
    "MailingAddressStateName": "OR",
    "MailingAddressPostalCode": "97045-8236",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "971-219-6774",
    "MailingAddressFaxNumber": null,
    "FirstLinePracticeLocationAddress": "16210 TRACEY LEE CT",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "OREGON CITY",
    "PracticeLocationAddressStateName": "OR",
    "PracticeLocationAddressPostalCode": "97045-8236",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "971-219-6774",
    "PracticeLocationAddressFaxNumber": null,
    "EnumerationDate": "06/02/2025",
    "LastUpdateDate": "06/02/2025",
    "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": "251J00000X",
        "TaxonomyName": "Nursing Care Agency",
        "LicenseNumber": "10027659",
        "LicenseNumberStateCode": "OR",
        "PrimaryTaxonomySwitch": "Y"
      }
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

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