{
"Npi": {
"NPI": "1962618264",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "NOEL 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": "PO BOX 631368",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "LITTLETON",
"MailingAddressStateName": "CO",
"MailingAddressPostalCode": "80163-1368",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "303-346-5524",
"MailingAddressFaxNumber": "303-346-5529",
"FirstLinePracticeLocationAddress": "9695 SOUTH YOSEMITE STREET",
"SecondLinePracticeLocationAddress": "SUITE 356",
"PracticeLocationAddressCityName": "LONE TREE",
"PracticeLocationAddressStateName": "CO",
"PracticeLocationAddressPostalCode": "80124-3191",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "303-346-5524",
"PracticeLocationAddressFaxNumber": "303-346-5529",
"EnumerationDate": "05/15/2007",
"LastUpdateDate": "11/05/2012",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "NOEL",
"AuthorizedOfficialFirstName": "PATRICK",
"AuthorizedOfficialMiddleName": "J",
"AuthorizedOfficialTitle": "DOCTOR",
"AuthorizedOfficialNamePrefix": "DR.",
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "D.C.",
"AuthorizedOfficialTelephoneNumber": "303-346-5524",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "111NS0005X",
"TaxonomyName": "Sports Physician Chiropractor",
"LicenseNumber": "4533",
"LicenseNumberStateCode": "CO",
"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."
}
}
}
}