{
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"IsOrgSubpart": "N",
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"OrgName": "REGIONAL REHABILITATION CENTER, INC.",
"LastName": null,
"FirstName": null,
"MiddleName": null,
"NamePrefix": null,
"NameSuffix": null,
"Credential": null,
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"OtherLastName": null,
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"OtherCredential": null,
"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "615 PEGRAM DR",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "TUPELO",
"MailingAddressStateName": "MS",
"MailingAddressPostalCode": "38801-6321",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "662-842-1891",
"MailingAddressFaxNumber": "662-840-0941",
"FirstLinePracticeLocationAddress": "615 PEGRAM DR",
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"PracticeLocationAddressCityName": "TUPELO",
"PracticeLocationAddressStateName": "MS",
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"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "662-842-1891",
"PracticeLocationAddressFaxNumber": "662-840-0941",
"EnumerationDate": "11/04/2008",
"LastUpdateDate": "11/04/2008",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "GAILLARD",
"AuthorizedOfficialFirstName": "VICKI",
"AuthorizedOfficialMiddleName": "BUTLER",
"AuthorizedOfficialTitle": "AUDIOLOGIST",
"AuthorizedOfficialNamePrefix": "MS.",
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "CCC-A",
"AuthorizedOfficialTelephoneNumber": "662-842-1891",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "231H00000X",
"TaxonomyName": "Audiologist",
"LicenseNumber": "A0737",
"LicenseNumberStateCode": "MS",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": {
"HealthcareProviderTaxonomyGroup": {
"HealthcareProviderTaxonomyGroupName": "193200000X MULTI-SPECIALTY GROUP",
"HealthcareProviderTaxonomyGroupDescription": "Multi-Specialty Group - A business group of one or more individual practitioners, who practice with different areas of specialization."
}
}
}
}