{
"Npi": {
"NPI": "1033305164",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "LAMONT PHYSICAL THERAPY-.",
"LastName": null,
"FirstName": null,
"MiddleName": null,
"NamePrefix": null,
"NameSuffix": null,
"Credential": null,
"OtherOrgName": null,
"OtherOrgNameTypeCode": null,
"OtherLastName": null,
"OtherFirstName": null,
"OtherMiddleName": null,
"OtherNamePrefix": null,
"OtherNameSuffix": null,
"OtherCredential": null,
"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "10130 MAIN ST",
"SecondLineMailingAddress": "STE., A",
"MailingAddressCityName": "LAMONT",
"MailingAddressStateName": "CA",
"MailingAddressPostalCode": "93241-1740",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "661-845-0600",
"MailingAddressFaxNumber": "661-845-0640",
"FirstLinePracticeLocationAddress": "10130 MAIN ST",
"SecondLinePracticeLocationAddress": "STE., A",
"PracticeLocationAddressCityName": "LAMONT",
"PracticeLocationAddressStateName": "CA",
"PracticeLocationAddressPostalCode": "93241-1740",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "661-845-0600",
"PracticeLocationAddressFaxNumber": "661-845-0640",
"EnumerationDate": "09/21/2007",
"LastUpdateDate": "01/19/2024",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "WHITESIDE",
"AuthorizedOfficialFirstName": "MICHAEL",
"AuthorizedOfficialMiddleName": "SHELTON",
"AuthorizedOfficialTitle": "PHYSICAL THERAPIST/OWNER",
"AuthorizedOfficialNamePrefix": "MR.",
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "PT",
"AuthorizedOfficialTelephoneNumber": "661-845-0600",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "261QP2000X",
"TaxonomyName": "Physical Therapy Clinic/Center",
"LicenseNumber": "OPT23092",
"LicenseNumberStateCode": "CA",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}