{
"Npi": {
"NPI": "1114242757",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "CARING MAN IN A VAN",
"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": "1021 INDUSTRIAL BLVD.",
"SecondLineMailingAddress": "SUITE B",
"MailingAddressCityName": "WATKINSVILLE",
"MailingAddressStateName": "GA",
"MailingAddressPostalCode": "30677",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "706-769-0075",
"MailingAddressFaxNumber": "800-849-1975",
"FirstLinePracticeLocationAddress": "1021 INDUSTRIAL BLVD",
"SecondLinePracticeLocationAddress": "SUITE B",
"PracticeLocationAddressCityName": "WATKINSVILLE",
"PracticeLocationAddressStateName": "GA",
"PracticeLocationAddressPostalCode": "30677-2761",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "706-769-0075",
"PracticeLocationAddressFaxNumber": "800-849-1975",
"EnumerationDate": "04/06/2010",
"LastUpdateDate": "10/09/2014",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "CHAMBERLAIN",
"AuthorizedOfficialFirstName": "MICHAEL",
"AuthorizedOfficialMiddleName": "SCOTT",
"AuthorizedOfficialTitle": "PRESIDENT / OWNER",
"AuthorizedOfficialNamePrefix": "MR.",
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": null,
"AuthorizedOfficialTelephoneNumber": "706-769-0075",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "343900000X",
"TaxonomyName": "Non-emergency Medical Transport (VAN)",
"LicenseNumber": "2010-275",
"LicenseNumberStateCode": "GA",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}