{
"Npi": {
"NPI": "1053691253",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "GULF COAST PHYSICAL THERAPY CENTERS PA",
"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": "PO BOX 3238",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "GULFPORT",
"MailingAddressStateName": "MS",
"MailingAddressPostalCode": "39505-3238",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "228-822-9066",
"MailingAddressFaxNumber": "228-822-9722",
"FirstLinePracticeLocationAddress": "1025 DIVISION ST STE A",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "BILOXI",
"PracticeLocationAddressStateName": "MS",
"PracticeLocationAddressPostalCode": "39530-2910",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "228-267-3582",
"PracticeLocationAddressFaxNumber": "228-822-9722",
"EnumerationDate": "08/19/2011",
"LastUpdateDate": "08/19/2011",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "PHILLIPS",
"AuthorizedOfficialFirstName": "MICHAEL",
"AuthorizedOfficialMiddleName": "N",
"AuthorizedOfficialTitle": "SECRETARY",
"AuthorizedOfficialNamePrefix": "MR.",
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "PT",
"AuthorizedOfficialTelephoneNumber": "228-822-9066",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "261QP2000X",
"TaxonomyName": "Physical Therapy Clinic/Center",
"LicenseNumber": null,
"LicenseNumberStateCode": null,
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}