{
"Npi": {
"NPI": "1083809958",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "RICE PLANTER PEDIATRICS LLC",
"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": "317 WINTERGREEN RD",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "WALTERBORO",
"MailingAddressStateName": "SC",
"MailingAddressPostalCode": "29488-9512",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "843-782-5437",
"MailingAddressFaxNumber": "843-782-4269",
"FirstLinePracticeLocationAddress": "416 ROBERTSON BLVD",
"SecondLinePracticeLocationAddress": "STE D",
"PracticeLocationAddressCityName": "WALTERBORO",
"PracticeLocationAddressStateName": "SC",
"PracticeLocationAddressPostalCode": "29488-2952",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "843-782-5437",
"PracticeLocationAddressFaxNumber": "843-782-4269",
"EnumerationDate": "09/13/2007",
"LastUpdateDate": "09/13/2007",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "GRANT",
"AuthorizedOfficialFirstName": "CHERYL",
"AuthorizedOfficialMiddleName": "ANTIONETTE",
"AuthorizedOfficialTitle": "OWNER",
"AuthorizedOfficialNamePrefix": "DR.",
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "MD",
"AuthorizedOfficialTelephoneNumber": "843-509-5848",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "261QM2500X",
"TaxonomyName": "Medical Specialty Clinic/Center",
"LicenseNumber": "25971",
"LicenseNumberStateCode": "SC",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}