{
"Npi": {
"NPI": "1124384623",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "TRI-CITIES INFECTIOUS DISEASE ASSOCIATES, P.C.",
"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": "505 N 6TH AVE",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "HOPEWELL",
"MailingAddressStateName": "VA",
"MailingAddressPostalCode": "23860-2618",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "804-452-2449",
"MailingAddressFaxNumber": "804-454-2870",
"FirstLinePracticeLocationAddress": "505 N 6TH AVE",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "HOPEWELL",
"PracticeLocationAddressStateName": "VA",
"PracticeLocationAddressPostalCode": "23860-2618",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "804-452-2449",
"PracticeLocationAddressFaxNumber": "804-454-2870",
"EnumerationDate": "04/09/2012",
"LastUpdateDate": "07/23/2013",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "LITTAUA",
"AuthorizedOfficialFirstName": "REBECCA",
"AuthorizedOfficialMiddleName": "ALEJANDRINO",
"AuthorizedOfficialTitle": "PRESIDENT",
"AuthorizedOfficialNamePrefix": "DR.",
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "M.D.",
"AuthorizedOfficialTelephoneNumber": "804-452-2449",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "207RI0200X",
"TaxonomyName": "Infectious Disease Physician",
"LicenseNumber": null,
"LicenseNumberStateCode": null,
"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."
}
}
}
}