{
"Npi": {
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"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "Y",
"ParentOrgLBN": "DR KEVIN D RHODES",
"ParentOrgTIN": null,
"OrgName": "ORTHOTIC LAB",
"LastName": null,
"FirstName": null,
"MiddleName": null,
"NamePrefix": null,
"NameSuffix": null,
"Credential": null,
"OtherOrgName": null,
"OtherOrgNameTypeCode": null,
"OtherLastName": null,
"OtherFirstName": null,
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"OtherNameSuffix": null,
"OtherCredential": null,
"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "800 8TH AVE STE 536",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "FORT WORTH",
"MailingAddressStateName": "TX",
"MailingAddressPostalCode": "76104-2604",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "817-332-5500",
"MailingAddressFaxNumber": "817-332-5503",
"FirstLinePracticeLocationAddress": "800 8TH AVE STE 536",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "FORT WORTH",
"PracticeLocationAddressStateName": "TX",
"PracticeLocationAddressPostalCode": "76104-2604",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "817-332-5500",
"PracticeLocationAddressFaxNumber": "817-332-5503",
"EnumerationDate": "08/02/2018",
"LastUpdateDate": "08/02/2018",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "RHODES",
"AuthorizedOfficialFirstName": "KEVIN",
"AuthorizedOfficialMiddleName": null,
"AuthorizedOfficialTitle": "OWNER",
"AuthorizedOfficialNamePrefix": "DR.",
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "DPM",
"AuthorizedOfficialTelephoneNumber": "817-332-5500",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "332BC3200X",
"TaxonomyName": "Customized Equipment (DME)",
"LicenseNumber": null,
"LicenseNumberStateCode": null,
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}