{
"Npi": {
"NPI": "1144369232",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "UNITED HEALTHCARE",
"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": "207 CRESTMONT WAY",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "CANTON",
"MailingAddressStateName": "GA",
"MailingAddressPostalCode": "30114-8875",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "678-493-7374",
"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "3720 DAVINCI CT",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "NORCROSS",
"PracticeLocationAddressStateName": "GA",
"PracticeLocationAddressPostalCode": "30092-7627",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "770-582-4484",
"PracticeLocationAddressFaxNumber": null,
"EnumerationDate": "02/05/2007",
"LastUpdateDate": "08/22/2020",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "PAGANO",
"AuthorizedOfficialFirstName": "JILL",
"AuthorizedOfficialMiddleName": "J",
"AuthorizedOfficialTitle": "HEALTH SERVICES DIRECTOR",
"AuthorizedOfficialNamePrefix": "MRS.",
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "NP",
"AuthorizedOfficialTelephoneNumber": "770-582-3985",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "302R00000X",
"TaxonomyName": "Health Maintenance Organization",
"LicenseNumber": "RN174554 NP",
"LicenseNumberStateCode": "GA",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}