{
"Npi": {
"NPI": "1053623157",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "BUTTERFLY BOUTIQUE, LLC",
"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": "1950 E 70TH ST STE G",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "SHREVEPORT",
"MailingAddressStateName": "LA",
"MailingAddressPostalCode": "71105-5345",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "318-798-5991",
"MailingAddressFaxNumber": "318-798-5992",
"FirstLinePracticeLocationAddress": "1950 E 70TH ST",
"SecondLinePracticeLocationAddress": "SUITE G",
"PracticeLocationAddressCityName": "SHREVEPORT",
"PracticeLocationAddressStateName": "LA",
"PracticeLocationAddressPostalCode": "71105-5345",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "318-798-5991",
"PracticeLocationAddressFaxNumber": "318-798-5992",
"EnumerationDate": "07/06/2010",
"LastUpdateDate": "03/14/2012",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "BYERS",
"AuthorizedOfficialFirstName": "CHERIE",
"AuthorizedOfficialMiddleName": null,
"AuthorizedOfficialTitle": "VICE PRESIDENT OF OPERATIONS",
"AuthorizedOfficialNamePrefix": null,
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": null,
"AuthorizedOfficialTelephoneNumber": "318-798-5991",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "335E00000X",
"TaxonomyName": "Prosthetic/Orthotic Supplier",
"LicenseNumber": "C49850",
"LicenseNumberStateCode": "LA",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}