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1861014276 NPI number — DIVINE BREAKTHROUGH MINISTRIES WORLDWIDE (THE BREAKTHROUGH CENTER)

NPI Number: 1861014276
Health Care Provider/Practitioner: DIVINE BREAKTHROUGH MINISTRIES WORLDWIDE (THE BREAKTHROUGH CENTER)

Information about “1861014276” NPI (DIVINE BREAKTHROUGH MINISTRIES WORLDWIDE (THE BREAKTHROUGH CENTER)) exists in 1861014276 in HTML format HTML  |  1861014276 in plain Text format TXT  |  1861014276 in PDF (Portable Document Format) PDF  |  1861014276 in an XML format XML  formats.

NPI Number : 1861014276 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1861014276",
    "EntityType": "Organization",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": null,
    "IsOrgSubpart": "Y",
    "ParentOrgLBN": "DIVINE BREAKTHROUGH MINISTRIES WORLDWIDE, INC",
    "ParentOrgTIN": null,
    "OrgName": "DIVINE BREAKTHROUGH MINISTRIES WORLDWIDE (THE BREAKTHROUGH CENTER)",
    "LastName": null,
    "FirstName": null,
    "MiddleName": null,
    "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": "9217 SPEERBERRY CIR",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "CORDOVA",
    "MailingAddressStateName": "TN",
    "MailingAddressPostalCode": "38016-2399",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "253-282-9802",
    "MailingAddressFaxNumber": null,
    "FirstLinePracticeLocationAddress": "9143 HWY 178",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "OLIVE BRANCH",
    "PracticeLocationAddressStateName": "MS",
    "PracticeLocationAddressPostalCode": "38654-3865",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "901-850-4469",
    "PracticeLocationAddressFaxNumber": "248-282-9802",
    "EnumerationDate": "05/08/2020",
    "LastUpdateDate": "05/07/2021",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": null,
    "Gender": null,
    "AuthorizedOfficialLastName": "EVERSON",
    "AuthorizedOfficialFirstName": "JOSEPH",
    "AuthorizedOfficialMiddleName": "RONDELL",
    "AuthorizedOfficialTitle": "DIRECTOR/PASTORAL COUNSELOR/MIDWIFE",
    "AuthorizedOfficialNamePrefix": "DR.",
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": "PSYD, PHD, DEM",
    "AuthorizedOfficialTelephoneNumber": "901-850-4469",
    "Taxonomies": {
      "Taxonomy": [
        {
          "TaxonomyCode": "176B00000X",
          "TaxonomyName": "Midwife",
          "LicenseNumber": null,
          "LicenseNumberStateCode": null,
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "101YP1600X",
          "TaxonomyName": "Pastoral Counselor",
          "LicenseNumber": null,
          "LicenseNumberStateCode": null,
          "PrimaryTaxonomySwitch": "Y"
        }
      ]
    },
    "HealthcareProviderTaxonomyGroups": {
      "HealthcareProviderTaxonomyGroup": [
        {
          "HealthcareProviderTaxonomyGroupName": "193400000X MULTIPLE 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."
        },
        {
          "HealthcareProviderTaxonomyGroupName": "193400000X MULTIPLE 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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