{
"Npi": {
"NPI": "1043208150",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "STERLING HEALTH CARE MANAGEMENT, 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": "1053 CLINIC DR",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "IVYDALE",
"MailingAddressStateName": "WV",
"MailingAddressPostalCode": "25113-8266",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "304-286-4204",
"MailingAddressFaxNumber": "304-286-3906",
"FirstLinePracticeLocationAddress": "1053 CLINIC DR",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "IVYDALE",
"PracticeLocationAddressStateName": "WV",
"PracticeLocationAddressPostalCode": "25113-8266",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "304-286-4204",
"PracticeLocationAddressFaxNumber": "304-286-3906",
"EnumerationDate": "10/12/2005",
"LastUpdateDate": "08/22/2020",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "TYLER",
"AuthorizedOfficialFirstName": "RAYMOND",
"AuthorizedOfficialMiddleName": "L.",
"AuthorizedOfficialTitle": "EXECUTIVE VICE PRESIDENT AND COO",
"AuthorizedOfficialNamePrefix": null,
"AuthorizedOfficialNameSuffix": "JR.",
"AuthorizedOfficialCredential": null,
"AuthorizedOfficialTelephoneNumber": "615-771-7575",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "314000000X",
"TaxonomyName": "Skilled Nursing Facility",
"LicenseNumber": "137",
"LicenseNumberStateCode": "WV",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}