{
"Npi": {
"NPI": "1144475823",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "HORIZON PEDIATRICS, LLC",
"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": "611 DEMOREST ST SE",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "LIVE OAK",
"MailingAddressStateName": "FL",
"MailingAddressPostalCode": "32064-3322",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "386-362-5437",
"MailingAddressFaxNumber": "386-362-5440",
"FirstLinePracticeLocationAddress": "611 DEMOREST ST SE",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "LIVE OAK",
"PracticeLocationAddressStateName": "FL",
"PracticeLocationAddressPostalCode": "32064-3322",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "386-362-5437",
"PracticeLocationAddressFaxNumber": "386-362-5440",
"EnumerationDate": "11/24/2008",
"LastUpdateDate": "11/24/2008",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "INGRAM",
"AuthorizedOfficialFirstName": "AMBER",
"AuthorizedOfficialMiddleName": "S.",
"AuthorizedOfficialTitle": "MANAGER",
"AuthorizedOfficialNamePrefix": "MRS.",
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "ARNP",
"AuthorizedOfficialTelephoneNumber": "386-362-5437",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "261QP2300X",
"TaxonomyName": "Primary Care Clinic/Center",
"LicenseNumber": null,
"LicenseNumberStateCode": null,
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}