{
"Npi": {
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"IsOrgSubpart": "N",
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"OrgName": "MIDDLE GA ORTHOPEADIC",
"LastName": null,
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"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "3370 ROSA CT",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "MACON",
"MailingAddressStateName": "GA",
"MailingAddressPostalCode": "31216-6737",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": null,
"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "3051 WATSON BLVD STE 400",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "WARNER ROBINS",
"PracticeLocationAddressStateName": "GA",
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"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "478-953-7556",
"PracticeLocationAddressFaxNumber": null,
"EnumerationDate": "04/17/2007",
"LastUpdateDate": "08/22/2020",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "THARPE",
"AuthorizedOfficialFirstName": "BRIAN",
"AuthorizedOfficialMiddleName": null,
"AuthorizedOfficialTitle": "FUNCTIONAL CAPACITY EVALUATOR",
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"AuthorizedOfficialCredential": "COTA, CEAS, CFCE",
"AuthorizedOfficialTelephoneNumber": "478-953-7556",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "261QP2000X",
"TaxonomyName": "Physical Therapy Clinic/Center",
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"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}