{
"Npi": {
"NPI": "1083371454",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "KATALYST HEALTHCARE CORPORATION",
"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": "9893 GEORGETOWN PIKE STE 143",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "GREAT FALLS",
"MailingAddressStateName": "VA",
"MailingAddressPostalCode": "22066-2617",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "703-263-8399",
"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "11350 RANDOM HILLS RD STE 800",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "FAIRFAX",
"PracticeLocationAddressStateName": "VA",
"PracticeLocationAddressPostalCode": "22030-6044",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "202-734-1298",
"PracticeLocationAddressFaxNumber": null,
"EnumerationDate": "11/20/2021",
"LastUpdateDate": "11/26/2021",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "NELSON, MD",
"AuthorizedOfficialFirstName": "MARC",
"AuthorizedOfficialMiddleName": null,
"AuthorizedOfficialTitle": "COO/CMO",
"AuthorizedOfficialNamePrefix": "DR.",
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "MD",
"AuthorizedOfficialTelephoneNumber": "703-982-6988",
"Taxonomies": {
"Taxonomy": [
{
"TaxonomyCode": "261QR1100X",
"TaxonomyName": "Research Clinic/Center",
"LicenseNumber": null,
"LicenseNumberStateCode": null,
"PrimaryTaxonomySwitch": "N"
},
{
"TaxonomyCode": "261QH0100X",
"TaxonomyName": "Health Service Clinic/Center",
"LicenseNumber": null,
"LicenseNumberStateCode": null,
"PrimaryTaxonomySwitch": "Y"
}
]
},
"HealthcareProviderTaxonomyGroups": null
}
}