{
"Npi": {
"NPI": "1053865204",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "SLEEP DATA HOLDINGS LLC",
"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": "5471 KEARNY VILLA RD.",
"SecondLineMailingAddress": "SUITE #200",
"MailingAddressCityName": "SAN DIEGO",
"MailingAddressStateName": "CA",
"MailingAddressPostalCode": "92123-1105",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "619-299-6299",
"MailingAddressFaxNumber": "619-299-6222",
"FirstLinePracticeLocationAddress": "1415 RIDGEBACK RD",
"SecondLinePracticeLocationAddress": "STE 1",
"PracticeLocationAddressCityName": "CHULA VISTA",
"PracticeLocationAddressStateName": "CA",
"PracticeLocationAddressPostalCode": "91910-6932",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "619-299-6299",
"PracticeLocationAddressFaxNumber": "619-299-6222",
"EnumerationDate": "08/04/2016",
"LastUpdateDate": "08/24/2021",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "BEINE",
"AuthorizedOfficialFirstName": "BRETTON",
"AuthorizedOfficialMiddleName": "DENISE",
"AuthorizedOfficialTitle": "PRESIDENT/COO",
"AuthorizedOfficialNamePrefix": null,
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": null,
"AuthorizedOfficialTelephoneNumber": "619-299-6299",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "332B00000X",
"TaxonomyName": "Durable Medical Equipment & Medical Supplies",
"LicenseNumber": null,
"LicenseNumberStateCode": null,
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}