{
"Npi": {
"NPI": "1013181791",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "POTOMAC INOVA HEALTHCARE ALLIANCE",
"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": "2990 TELESTAR CT",
"SecondLineMailingAddress": "SUITE 3PI",
"MailingAddressCityName": "FALLS CHURCH",
"MailingAddressStateName": "VA",
"MailingAddressPostalCode": "22042-1207",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "571-423-5727",
"MailingAddressFaxNumber": "571-423-5701",
"FirstLinePracticeLocationAddress": "2296 OPITZ BLVD",
"SecondLinePracticeLocationAddress": "SUITE 140",
"PracticeLocationAddressCityName": "WOODBRIDGE",
"PracticeLocationAddressStateName": "VA",
"PracticeLocationAddressPostalCode": "22191-3300",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "703-670-3349",
"PracticeLocationAddressFaxNumber": "703-580-0730",
"EnumerationDate": "04/15/2008",
"LastUpdateDate": "02/26/2013",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "MASON",
"AuthorizedOfficialFirstName": "JACKIE",
"AuthorizedOfficialMiddleName": null,
"AuthorizedOfficialTitle": "DIRECTOR",
"AuthorizedOfficialNamePrefix": "MS.",
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": null,
"AuthorizedOfficialTelephoneNumber": "703-670-3349",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "261QX0203X",
"TaxonomyName": "Radiation Oncology Clinic/Center",
"LicenseNumber": null,
"LicenseNumberStateCode": null,
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}