{
"Npi": {
"NPI": "1134306335",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "ATOKA MANOR INC",
"LastName": null,
"FirstName": null,
"MiddleName": null,
"NamePrefix": null,
"NameSuffix": null,
"Credential": null,
"OtherOrgName": null,
"OtherOrgNameTypeCode": "6",
"OtherLastName": null,
"OtherFirstName": null,
"OtherMiddleName": null,
"OtherNamePrefix": null,
"OtherNameSuffix": null,
"OtherCredential": null,
"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "1500 S VIRGINIA AVE",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "ATOKA",
"MailingAddressStateName": "OK",
"MailingAddressPostalCode": "74525-3246",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "580-889-2500",
"MailingAddressFaxNumber": "580-889-2888",
"FirstLinePracticeLocationAddress": "1500 S VIRGINIA AVE",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "ATOKA",
"PracticeLocationAddressStateName": "OK",
"PracticeLocationAddressPostalCode": "74525-3246",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "580-889-2500",
"PracticeLocationAddressFaxNumber": "580-889-2888",
"EnumerationDate": "01/30/2008",
"LastUpdateDate": "03/12/2012",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "WALKER",
"AuthorizedOfficialFirstName": "TRACI",
"AuthorizedOfficialMiddleName": "DIANN",
"AuthorizedOfficialTitle": "CHAIR PERSON",
"AuthorizedOfficialNamePrefix": "MS.",
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": null,
"AuthorizedOfficialTelephoneNumber": "580-364-2286",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "314000000X",
"TaxonomyName": "Skilled Nursing Facility",
"LicenseNumber": "NH0302-0302",
"LicenseNumberStateCode": "OK",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}