{
"Npi": {
"NPI": "1114132883",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "BUILDING BRIDGES THERAPY CENTER",
"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": "820 E HIGHWAY 171",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "HOT SPRINGS",
"MailingAddressStateName": "AR",
"MailingAddressPostalCode": "71913-8614",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "501-620-8801",
"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "316 BLACKFIN DR",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "RUSSELLVILLE",
"PracticeLocationAddressStateName": "AR",
"PracticeLocationAddressPostalCode": "72802-2295",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "501-467-0101",
"PracticeLocationAddressFaxNumber": null,
"EnumerationDate": "05/14/2007",
"LastUpdateDate": "06/16/2008",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "POWELL",
"AuthorizedOfficialFirstName": "JENNIFER",
"AuthorizedOfficialMiddleName": "N.",
"AuthorizedOfficialTitle": "SPEECH PATHOLOGY ASSISTANT",
"AuthorizedOfficialNamePrefix": "MISS",
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "SLPA",
"AuthorizedOfficialTelephoneNumber": "501-620-8801",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "2355S0801X",
"TaxonomyName": "Speech-Language Assistant",
"LicenseNumber": "06-005",
"LicenseNumberStateCode": "AR",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": {
"HealthcareProviderTaxonomyGroup": {
"HealthcareProviderTaxonomyGroupName": "193400000X MULTIPLE 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."
}
}
}
}