NPI Code Detail JSON Logo

1962573170 NPI number — PRIMESOURCE NURSING SERVICES, INC

NPI Number: 1962573170
Health Care Provider/Practitioner: PRIMESOURCE NURSING SERVICES, INC

Information about “1962573170” NPI (PRIMESOURCE NURSING SERVICES, INC) exists in 1962573170 in HTML format HTML  |  1962573170 in plain Text format TXT  |  1962573170 in PDF (Portable Document Format) PDF  |  1962573170 in an XML format XML  formats.

NPI Number : 1962573170 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1962573170",
    "EntityType": "Organization",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": null,
    "IsOrgSubpart": "N",
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": "PRIMESOURCE NURSING SERVICES, INC",
    "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": "PO BOX 6705",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "GULFPORT",
    "MailingAddressStateName": "MS",
    "MailingAddressPostalCode": "39506-6705",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "228-865-1330",
    "MailingAddressFaxNumber": "228-865-1331",
    "FirstLinePracticeLocationAddress": "370 COURTHOUSE RD STE 106",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "GULFPORT",
    "PracticeLocationAddressStateName": "MS",
    "PracticeLocationAddressPostalCode": "39507-1889",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "228-865-1330",
    "PracticeLocationAddressFaxNumber": "228-865-1331",
    "EnumerationDate": "11/10/2006",
    "LastUpdateDate": "01/20/2025",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": null,
    "Gender": null,
    "AuthorizedOfficialLastName": "PLAUCHE",
    "AuthorizedOfficialFirstName": "RHETT",
    "AuthorizedOfficialMiddleName": "M",
    "AuthorizedOfficialTitle": "PRESIDENT",
    "AuthorizedOfficialNamePrefix": "MRS.",
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": null,
    "AuthorizedOfficialTelephoneNumber": "228-865-1330",
    "Taxonomies": {
      "Taxonomy": [
        {
          "TaxonomyCode": "1041C0700X",
          "TaxonomyName": "Clinical Social Worker",
          "LicenseNumber": null,
          "LicenseNumberStateCode": null,
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "363LF0000X",
          "TaxonomyName": "Family Nurse Practitioner",
          "LicenseNumber": "7381",
          "LicenseNumberStateCode": "MS",
          "PrimaryTaxonomySwitch": "Y"
        }
      ]
    },
    "HealthcareProviderTaxonomyGroups": {
      "HealthcareProviderTaxonomyGroup": [
        {
          "HealthcareProviderTaxonomyGroupName": "193200000X MULTI-SPECIALTY GROUP",
          "HealthcareProviderTaxonomyGroupDescription": "Multi-Specialty Group - A business group of one or more individual practitioners, who practice with different areas of specialization."
        },
        {
          "HealthcareProviderTaxonomyGroupName": "193200000X MULTI-SPECIALTY GROUP",
          "HealthcareProviderTaxonomyGroupDescription": "Multi-Specialty Group - A business group of one or more individual practitioners, who practice with different areas of specialization."
        }
      ]
    }
  }
}
                
            

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