{
"Npi": {
"NPI": "1154565505",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "PHILLIPS COUNTY TRANSPORTATION",
"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": "4440 RYAN ST",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "MEMPHIS",
"MailingAddressStateName": "TN",
"MailingAddressPostalCode": "38127-2829",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "901-267-3939",
"MailingAddressFaxNumber": "662-536-3368",
"FirstLinePracticeLocationAddress": "1444 TRAFALGAR CV",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "SOUTHAVEN",
"PracticeLocationAddressStateName": "MS",
"PracticeLocationAddressPostalCode": "38671-8988",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "901-489-3890",
"PracticeLocationAddressFaxNumber": "662-536-3368",
"EnumerationDate": "04/29/2009",
"LastUpdateDate": "05/05/2009",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "AKINBOBOYE",
"AuthorizedOfficialFirstName": "FELIX",
"AuthorizedOfficialMiddleName": "R",
"AuthorizedOfficialTitle": "OWNER",
"AuthorizedOfficialNamePrefix": "MR.",
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "TRANSPOTATION",
"AuthorizedOfficialTelephoneNumber": "901-489-3890",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "343900000X",
"TaxonomyName": "Non-emergency Medical Transport (VAN)",
"LicenseNumber": null,
"LicenseNumberStateCode": "TN",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}