{
"Npi": {
"NPI": "1063925303",
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"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "LEGACY LIVING",
"LastName": null,
"FirstName": null,
"MiddleName": null,
"NamePrefix": null,
"NameSuffix": null,
"Credential": null,
"OtherOrgName": null,
"OtherOrgNameTypeCode": null,
"OtherLastName": null,
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"OtherNamePrefix": null,
"OtherNameSuffix": null,
"OtherCredential": null,
"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "445 E 10TH ST",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "BAXTER SPRINGS",
"MailingAddressStateName": "KS",
"MailingAddressPostalCode": "66713-1614",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "620-856-2756",
"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "445 E 10TH ST",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "BAXTER SPRINGS",
"PracticeLocationAddressStateName": "KS",
"PracticeLocationAddressPostalCode": "66713-1614",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "620-856-2756",
"PracticeLocationAddressFaxNumber": null,
"EnumerationDate": "11/08/2017",
"LastUpdateDate": "11/08/2017",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "DOTSON",
"AuthorizedOfficialFirstName": "RANDY",
"AuthorizedOfficialMiddleName": "DUKE",
"AuthorizedOfficialTitle": "OWNER/OPERATOR",
"AuthorizedOfficialNamePrefix": null,
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": null,
"AuthorizedOfficialTelephoneNumber": "620-387-0005",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "311ZA0620X",
"TaxonomyName": "Adult Care Home Facility",
"LicenseNumber": "B011004",
"LicenseNumberStateCode": "KS",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}