1952656506 NPI number — ROBERT LEE CARPENTER R.N., MASSAGE TPST.

NPI Number: 1952656506
Health Care Provider/Practitioner: ROBERT LEE CARPENTER R.N., MASSAGE TPST.

NPI Number : 1952656506 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1952656506",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "Y",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "CARPENTER",
    "FirstName": "ROBERT",
    "MiddleName": "LEE",
    "NamePrefix": "MR.",
    "NameSuffix": null,
    "Credential": "R.N., MASSAGE TPST.",
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": null,
    "OtherFirstName": null,
    "OtherMiddleName": null,
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": null,
    "FirstLineMailingAddress": "610 ATTLA WAY",
    "SecondLineMailingAddress": "SUITE 10",
    "MailingAddressCityName": "KENAI",
    "MailingAddressStateName": "AK",
    "MailingAddressPostalCode": "99611-7736",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "907-598-4263",
    "MailingAddressFaxNumber": null,
    "FirstLinePracticeLocationAddress": "610 ATTLA WAY",
    "SecondLinePracticeLocationAddress": "SUITE 10",
    "PracticeLocationAddressCityName": "KENAI",
    "PracticeLocationAddressStateName": "AK",
    "PracticeLocationAddressPostalCode": "99611-7736",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "907-598-4263",
    "PracticeLocationAddressFaxNumber": null,
    "EnumerationDate": "07/19/2012",
    "LastUpdateDate": "10/23/2012",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": "M",
    "Gender": "Male",
    "AuthorizedOfficialLastName": null,
    "AuthorizedOfficialFirstName": null,
    "AuthorizedOfficialMiddleName": null,
    "AuthorizedOfficialTitle": null,
    "AuthorizedOfficialNamePrefix": null,
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": null,
    "AuthorizedOfficialTelephoneNumber": null,
    "Taxonomies": {
      "Taxonomy": [
        {
          "TaxonomyCode": "163W00000X",
          "TaxonomyName": "Registered Nurse",
          "LicenseNumber": "28163",
          "LicenseNumberStateCode": "AK",
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "163WM1400X",
          "TaxonomyName": "Nurse Massage Therapist (NMT)",
          "LicenseNumber": "28163",
          "LicenseNumberStateCode": "AK",
          "PrimaryTaxonomySwitch": "Y"
        }
      ]
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}