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1982029641 NPI number — LINDSAY REAY GROSVENOR RD

NPI Number: 1982029641
Health Care Provider/Practitioner: LINDSAY REAY GROSVENOR RD

Information about “1982029641” NPI (LINDSAY REAY GROSVENOR RD) exists in 1982029641 in HTML format HTML  |  1982029641 in plain Text format TXT  |  1982029641 in PDF (Portable Document Format) PDF  |  1982029641 in an XML format XML  formats.

NPI Number : 1982029641 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1982029641",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "Y",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "GROSVENOR",
    "FirstName": "LINDSAY",
    "MiddleName": "REAY",
    "NamePrefix": "MRS.",
    "NameSuffix": null,
    "Credential": "RD",
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": null,
    "OtherFirstName": null,
    "OtherMiddleName": null,
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": null,
    "FirstLineMailingAddress": "1108 SW 4TH ST",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "ONTARIO",
    "MailingAddressStateName": "OR",
    "MailingAddressPostalCode": "97914-4305",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "541-889-7041",
    "MailingAddressFaxNumber": "541-823-9400",
    "FirstLinePracticeLocationAddress": "1108 SW 4TH ST",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "ONTARIO",
    "PracticeLocationAddressStateName": "OR",
    "PracticeLocationAddressPostalCode": "97914-4305",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "541-889-7041",
    "PracticeLocationAddressFaxNumber": "541-823-9400",
    "EnumerationDate": "03/04/2014",
    "LastUpdateDate": "03/04/2014",
    "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": "133V00000X",
        "TaxonomyName": "Registered Dietitian",
        "LicenseNumber": "895201",
        "LicenseNumberStateCode": null,
        "PrimaryTaxonomySwitch": "Y"
      }
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

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