{
"Npi": {
"NPI": "1003299108",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "CENTRAL PENINSULA GENERAL HOSPITAL, INC",
"LastName": null,
"FirstName": null,
"MiddleName": null,
"NamePrefix": null,
"NameSuffix": null,
"Credential": null,
"OtherOrgName": null,
"OtherOrgNameTypeCode": "6",
"OtherLastName": null,
"OtherFirstName": null,
"OtherMiddleName": null,
"OtherNamePrefix": null,
"OtherNameSuffix": null,
"OtherCredential": null,
"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "250 HOSPITAL PL",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "SOLDOTNA",
"MailingAddressStateName": "AK",
"MailingAddressPostalCode": "99669-7559",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "907-714-4404",
"MailingAddressFaxNumber": "907-714-4696",
"FirstLinePracticeLocationAddress": "805 FRONTAGE RD",
"SecondLinePracticeLocationAddress": "SUITE 123",
"PracticeLocationAddressCityName": "KENAI",
"PracticeLocationAddressStateName": "AK",
"PracticeLocationAddressPostalCode": "99611-9104",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "907-283-4611",
"PracticeLocationAddressFaxNumber": "907-283-3992",
"EnumerationDate": "07/07/2015",
"LastUpdateDate": "07/07/2015",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "DAVIS",
"AuthorizedOfficialFirstName": "RICHARD",
"AuthorizedOfficialMiddleName": null,
"AuthorizedOfficialTitle": "CEO",
"AuthorizedOfficialNamePrefix": null,
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": null,
"AuthorizedOfficialTelephoneNumber": "907-714-4723",
"Taxonomies": {
"Taxonomy": [
{
"TaxonomyCode": "282NR1301X",
"TaxonomyName": "Rural Acute Care Hospital",
"LicenseNumber": "GACH-003",
"LicenseNumberStateCode": "AK",
"PrimaryTaxonomySwitch": "N"
},
{
"TaxonomyCode": "207Q00000X",
"TaxonomyName": "Family Medicine Physician",
"LicenseNumber": null,
"LicenseNumberStateCode": "AK",
"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."
}
}
}
}