{
"Npi": {
"NPI": "1063146447",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "DYNAMIC BY DESIGN PROSTHETICS, PLLC",
"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": "5373 W ALABAMA ST STE 576",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "HOUSTON",
"MailingAddressStateName": "TX",
"MailingAddressPostalCode": "77056-5923",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "832-899-4268",
"MailingAddressFaxNumber": "877-559-1081",
"FirstLinePracticeLocationAddress": "5373 W ALABAMA ST STE 204",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "HOUSTON",
"PracticeLocationAddressStateName": "TX",
"PracticeLocationAddressPostalCode": "77056-5923",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "832-899-4268",
"PracticeLocationAddressFaxNumber": "877-559-1081",
"EnumerationDate": "07/12/2022",
"LastUpdateDate": "07/12/2022",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "RYPINSKI",
"AuthorizedOfficialFirstName": "TATIANA",
"AuthorizedOfficialMiddleName": null,
"AuthorizedOfficialTitle": "LICENSED PROSTHETIST ORTHOTIST",
"AuthorizedOfficialNamePrefix": null,
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "LPO",
"AuthorizedOfficialTelephoneNumber": "240-441-8513",
"Taxonomies": {
"Taxonomy": [
{
"TaxonomyCode": "335E00000X",
"TaxonomyName": "Prosthetic/Orthotic Supplier",
"LicenseNumber": null,
"LicenseNumberStateCode": null,
"PrimaryTaxonomySwitch": "N"
},
{
"TaxonomyCode": "222Z00000X",
"TaxonomyName": "Orthotist",
"LicenseNumber": null,
"LicenseNumberStateCode": null,
"PrimaryTaxonomySwitch": "N"
},
{
"TaxonomyCode": "224P00000X",
"TaxonomyName": "Prosthetist",
"LicenseNumber": null,
"LicenseNumberStateCode": null,
"PrimaryTaxonomySwitch": "Y"
}
]
},
"HealthcareProviderTaxonomyGroups": {
"HealthcareProviderTaxonomyGroup": [
{
"HealthcareProviderTaxonomyGroupName": "193200000X MULTI-SPECIALTY GROUP",
"HealthcareProviderTaxonomyGroupDescription": "Multi-Specialty Group - A business group of one or more individual practitioners, who practice with different areas of specialization."
},
{
"HealthcareProviderTaxonomyGroupName": "193200000X MULTI-SPECIALTY GROUP",
"HealthcareProviderTaxonomyGroupDescription": "Multi-Specialty Group - A business group of one or more individual practitioners, who practice with different areas of specialization."
}
]
}
}
}