NPI Code Detail JSON Logo

1902611999 NPI number — STEPHANIE JILL GOLDMAN LMT

NPI Number: 1902611999
Health Care Provider/Practitioner: STEPHANIE JILL GOLDMAN LMT

Information about “1902611999” NPI (STEPHANIE JILL GOLDMAN LMT) exists in 1902611999 in HTML format HTML  |  1902611999 in plain Text format TXT  |  1902611999 in PDF (Portable Document Format) PDF  |  1902611999 in an XML format XML  formats.

NPI Number : 1902611999 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1902611999",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "N",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "GOLDMAN",
    "FirstName": "STEPHANIE",
    "MiddleName": "JILL",
    "NamePrefix": null,
    "NameSuffix": null,
    "Credential": "LMT",
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": "WELLNESS",
    "OtherFirstName": "LOTUS",
    "OtherMiddleName": "BLOSSOM YOGA",
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": "5",
    "FirstLineMailingAddress": "4512 SE LEE BLVD",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "LAWTON",
    "MailingAddressStateName": "OK",
    "MailingAddressPostalCode": "73501-6558",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "580-860-6104",
    "MailingAddressFaxNumber": null,
    "FirstLinePracticeLocationAddress": "4512 SE LEE BLVD",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "LAWTON",
    "PracticeLocationAddressStateName": "OK",
    "PracticeLocationAddressPostalCode": "73501-6558",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "580-860-6104",
    "PracticeLocationAddressFaxNumber": null,
    "EnumerationDate": "02/08/2025",
    "LastUpdateDate": "11/11/2025",
    "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": "374J00000X",
          "TaxonomyName": "Doula",
          "LicenseNumber": null,
          "LicenseNumberStateCode": "OK",
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "173C00000X",
          "TaxonomyName": "Reflexologist",
          "LicenseNumber": null,
          "LicenseNumberStateCode": "OK",
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "225700000X",
          "TaxonomyName": "Massage Therapist",
          "LicenseNumber": "90783",
          "LicenseNumberStateCode": "OK",
          "PrimaryTaxonomySwitch": "Y"
        }
      ]
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

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