{
"Npi": {
"NPI": "1063528339",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "INNOVATIVE MEDICAL SOLUTIONS",
"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": "303 FALLS DR NW",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "ABINGDON",
"MailingAddressStateName": "VA",
"MailingAddressPostalCode": "24210-8093",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "276-676-3133",
"MailingAddressFaxNumber": "276-676-0818",
"FirstLinePracticeLocationAddress": "303 FALLS DR NW",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "ABINGDON",
"PracticeLocationAddressStateName": "VA",
"PracticeLocationAddressPostalCode": "24210-8093",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "276-676-3133",
"PracticeLocationAddressFaxNumber": "276-676-0818",
"EnumerationDate": "08/21/2006",
"LastUpdateDate": "08/22/2020",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "MARTIN",
"AuthorizedOfficialFirstName": "NANCY",
"AuthorizedOfficialMiddleName": "TAYLOR",
"AuthorizedOfficialTitle": "OWNER",
"AuthorizedOfficialNamePrefix": "MS.",
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "RRT",
"AuthorizedOfficialTelephoneNumber": "276-676-3133",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "332BX2000X",
"TaxonomyName": "Oxygen Equipment & Supplies (DME)",
"LicenseNumber": "0206009127",
"LicenseNumberStateCode": "VA",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}