{
"Npi": {
"NPI": "1174057194",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "HEALTHCARE AT HOME 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": "5243 SNAPFINGER WOODS DR STE 104",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "DECATUR",
"MailingAddressStateName": "GA",
"MailingAddressPostalCode": "30035-4000",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "678-777-7165",
"MailingAddressFaxNumber": "563-202-6972",
"FirstLinePracticeLocationAddress": "5040 SNAPFINGER WOODS DR STE 104",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "DECATUR",
"PracticeLocationAddressStateName": "GA",
"PracticeLocationAddressPostalCode": "30035-4020",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "678-777-7165",
"PracticeLocationAddressFaxNumber": "563-202-6972",
"EnumerationDate": "04/17/2017",
"LastUpdateDate": "04/26/2022",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "SALMON ANDERSON",
"AuthorizedOfficialFirstName": "TRICIA",
"AuthorizedOfficialMiddleName": null,
"AuthorizedOfficialTitle": "FAMILY NURSE PRACTITIONER",
"AuthorizedOfficialNamePrefix": "DR.",
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "DNP, FNP-C",
"AuthorizedOfficialTelephoneNumber": "678-777-7165",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "363LF0000X",
"TaxonomyName": "Family Nurse Practitioner",
"LicenseNumber": "195112",
"LicenseNumberStateCode": "GA",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": {
"HealthcareProviderTaxonomyGroup": {
"HealthcareProviderTaxonomyGroupName": "193400000X SINGLE SPECIALTY GROUP",
"HealthcareProviderTaxonomyGroupDescription": "Single Specialty Group - A business group of one or more individual practitioners, all of who practice with the same area of specialization."
}
}
}
}