{
"Npi": {
"NPI": "1205067113",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "THE AUDIOLOGY CENTER OF LORAIN CO. INC",
"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": "6100 S BROADWAY SUITE-102",
"SecondLineMailingAddress": "THE AUDIOLOGY CENTER",
"MailingAddressCityName": "LORAIN",
"MailingAddressStateName": "OH",
"MailingAddressPostalCode": "44053-3875",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "440-246-4327",
"MailingAddressFaxNumber": "440-246-4327",
"FirstLinePracticeLocationAddress": "6100 S BROADWAY SUITE 102",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "LORAIN",
"PracticeLocationAddressStateName": "OH",
"PracticeLocationAddressPostalCode": "44053-3875",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "440-246-4327",
"PracticeLocationAddressFaxNumber": "440-246-4327",
"EnumerationDate": "07/28/2009",
"LastUpdateDate": "07/28/2009",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "MITHCHELL",
"AuthorizedOfficialFirstName": "LILLIAN",
"AuthorizedOfficialMiddleName": "REYNOLDS",
"AuthorizedOfficialTitle": "PRESIDENT-OWNER-AUDIOLOGIST",
"AuthorizedOfficialNamePrefix": "MRS.",
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "MA-CCCA FAAA",
"AuthorizedOfficialTelephoneNumber": "440-246-4327",
"Taxonomies": {
"Taxonomy": [
{
"TaxonomyCode": "332S00000X",
"TaxonomyName": "Hearing Aid Equipment",
"LicenseNumber": null,
"LicenseNumberStateCode": null,
"PrimaryTaxonomySwitch": "N"
},
{
"TaxonomyCode": "231H00000X",
"TaxonomyName": "Audiologist",
"LicenseNumber": "A0171",
"LicenseNumberStateCode": "OH",
"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."
}
}
}
}