{
"Npi": {
"NPI": "1194236240",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "NORTHLAND HEARING CENTER, INC.",
"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": "8800 SE SUNNYSIDE RD STE 300N",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "CLACKAMAS",
"MailingAddressStateName": "OR",
"MailingAddressPostalCode": "97015-5703",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "281-286-2999",
"MailingAddressFaxNumber": "512-607-4893",
"FirstLinePracticeLocationAddress": "184 OLD MOUSE CREEK RD NW",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "CLEVELAND",
"PracticeLocationAddressStateName": "TN",
"PracticeLocationAddressPostalCode": "37312-3835",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "423-479-7356",
"PracticeLocationAddressFaxNumber": null,
"EnumerationDate": "10/17/2017",
"LastUpdateDate": "05/02/2018",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "MELES",
"AuthorizedOfficialFirstName": "JENNIFER",
"AuthorizedOfficialMiddleName": null,
"AuthorizedOfficialTitle": "DIRECTOR OF FINANCE",
"AuthorizedOfficialNamePrefix": null,
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": null,
"AuthorizedOfficialTelephoneNumber": "952-947-4889",
"Taxonomies": {
"Taxonomy": [
{
"TaxonomyCode": "332S00000X",
"TaxonomyName": "Hearing Aid Equipment",
"LicenseNumber": null,
"LicenseNumberStateCode": null,
"PrimaryTaxonomySwitch": "N"
},
{
"TaxonomyCode": "261QH0700X",
"TaxonomyName": "Hearing and Speech Clinic/Center",
"LicenseNumber": null,
"LicenseNumberStateCode": null,
"PrimaryTaxonomySwitch": "Y"
}
]
},
"HealthcareProviderTaxonomyGroups": null
}
}