{
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"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
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"OrgName": "ELITE PHYSICIANS GROUP",
"LastName": null,
"FirstName": null,
"MiddleName": null,
"NamePrefix": null,
"NameSuffix": null,
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"OtherOrgNameTypeCode": null,
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"OtherCredential": null,
"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "9005 OVERLOOK BLVD",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "BRENTWOOD",
"MailingAddressStateName": "TN",
"MailingAddressPostalCode": "37027-5269",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "615-873-2975",
"MailingAddressFaxNumber": "615-873-2975",
"FirstLinePracticeLocationAddress": "9005 OVERLOOK BLVD",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "BRENTWOOD",
"PracticeLocationAddressStateName": "TN",
"PracticeLocationAddressPostalCode": "37027-5269",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "615-873-2975",
"PracticeLocationAddressFaxNumber": "615-873-2975",
"EnumerationDate": "05/03/2018",
"LastUpdateDate": "05/03/2018",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "SASSER",
"AuthorizedOfficialFirstName": "CASEY",
"AuthorizedOfficialMiddleName": "WILLIAM",
"AuthorizedOfficialTitle": "CO-OWNER/PARTNER",
"AuthorizedOfficialNamePrefix": "MR.",
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "N.P.",
"AuthorizedOfficialTelephoneNumber": "931-206-3549",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "207R00000X",
"TaxonomyName": "Internal Medicine Physician",
"LicenseNumber": "54921",
"LicenseNumberStateCode": "TN",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": {
"HealthcareProviderTaxonomyGroup": {
"HealthcareProviderTaxonomyGroupName": "193400000X SINGLE SPECIALTY GROUP",
"HealthcareProviderTaxonomyGroupDescription": "Single Specialty Group - A business group of one or more individual practitioners, all of who practice with the same area of specialization."
}
}
}
}