1982065843 NPI number — MEGAN CAMPBELL M.S., A.T.C., C.E.S.

NPI Number: 1982065843
Health Care Provider/Practitioner: MEGAN CAMPBELL M.S., A.T.C., C.E.S.

NPI Number : 1982065843 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1982065843",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "Y",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "CAMPBELL",
    "FirstName": "MEGAN",
    "MiddleName": null,
    "NamePrefix": null,
    "NameSuffix": null,
    "Credential": "M.S., A.T.C., C.E.S.",
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": null,
    "OtherFirstName": null,
    "OtherMiddleName": null,
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": null,
    "FirstLineMailingAddress": "47201 CALCUTTA SMITHFERRY RD",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "EAST LIVERPOOL",
    "MailingAddressStateName": "OH",
    "MailingAddressPostalCode": "43920-9004",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "330-383-1933",
    "MailingAddressFaxNumber": null,
    "FirstLinePracticeLocationAddress": "195 GOLDEN BEAR DR",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "NEW CUMBERLAND",
    "PracticeLocationAddressStateName": "WV",
    "PracticeLocationAddressPostalCode": "26047-1672",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "330-383-1933",
    "PracticeLocationAddressFaxNumber": null,
    "EnumerationDate": "03/18/2016",
    "LastUpdateDate": "03/18/2016",
    "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": "2255A2300X",
          "TaxonomyName": "Athletic Trainer",
          "LicenseNumber": "AT001347",
          "LicenseNumberStateCode": "WV",
          "PrimaryTaxonomySwitch": "Y"
        },
        {
          "TaxonomyCode": "2255A2300X",
          "TaxonomyName": "Athletic Trainer",
          "LicenseNumber": "AT.004242",
          "LicenseNumberStateCode": "OH",
          "PrimaryTaxonomySwitch": "N"
        }
      ]
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}