{
"Npi": {
"NPI": "1902105836",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "INSPIRED WELLNESS CHIROPRACTIC LLC",
"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": "1927 W 13800 S",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "RIVERTON",
"MailingAddressStateName": "UT",
"MailingAddressPostalCode": "84065-5373",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "801-815-6252",
"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "8541 REDWOOD RD # D",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "WEST JORDAN",
"PracticeLocationAddressStateName": "UT",
"PracticeLocationAddressPostalCode": "84088-9327",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "801-233-9050",
"PracticeLocationAddressFaxNumber": "801-233-9051",
"EnumerationDate": "03/17/2011",
"LastUpdateDate": "03/22/2011",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "HANSEN",
"AuthorizedOfficialFirstName": "DANIEL",
"AuthorizedOfficialMiddleName": "ROBERT",
"AuthorizedOfficialTitle": "OWNER",
"AuthorizedOfficialNamePrefix": null,
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "D.C.",
"AuthorizedOfficialTelephoneNumber": "801-233-9050",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "111N00000X",
"TaxonomyName": "Chiropractor",
"LicenseNumber": "74040491202",
"LicenseNumberStateCode": "UT",
"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."
}
}
}
}