{
"Npi": {
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"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "MUSCLE & SPINE REHABILITATION CENTER LLC",
"LastName": null,
"FirstName": null,
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"NamePrefix": null,
"NameSuffix": null,
"Credential": null,
"OtherOrgName": null,
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"OtherCredential": null,
"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "2545 CAPITAL AVE SW STE 140",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "BATTLE CREEK",
"MailingAddressStateName": "MI",
"MailingAddressPostalCode": "49015-7103",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "269-979-3000",
"MailingAddressFaxNumber": "269-979-9770",
"FirstLinePracticeLocationAddress": "2545 CAPITAL AVE SW STE 140",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "BATTLE CREEK",
"PracticeLocationAddressStateName": "MI",
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"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "269-979-3000",
"PracticeLocationAddressFaxNumber": "269-979-9770",
"EnumerationDate": "09/21/2006",
"LastUpdateDate": "12/28/2023",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "ESSEX",
"AuthorizedOfficialFirstName": "ROBERT",
"AuthorizedOfficialMiddleName": "L",
"AuthorizedOfficialTitle": "PRESIDENT",
"AuthorizedOfficialNamePrefix": "DR.",
"AuthorizedOfficialNameSuffix": "JR.",
"AuthorizedOfficialCredential": "PT, MS, DPT, OCS",
"AuthorizedOfficialTelephoneNumber": "269-979-3000",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "261QP2000X",
"TaxonomyName": "Physical Therapy Clinic/Center",
"LicenseNumber": "5501004323-PT/MI",
"LicenseNumberStateCode": "MI",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}