{
"Npi": {
"NPI": "1215253976",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "SOUTHFORK CHIROPRACTIC",
"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": "517 W FM 544",
"SecondLineMailingAddress": "SUITE 200",
"MailingAddressCityName": "MURPHY",
"MailingAddressStateName": "TX",
"MailingAddressPostalCode": "75094-4621",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "972-578-2225",
"MailingAddressFaxNumber": "972-578-2201",
"FirstLinePracticeLocationAddress": "517 W FM 544",
"SecondLinePracticeLocationAddress": "SUITE 200",
"PracticeLocationAddressCityName": "MURPHY",
"PracticeLocationAddressStateName": "TX",
"PracticeLocationAddressPostalCode": "75094-4621",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "972-578-2225",
"PracticeLocationAddressFaxNumber": "972-578-2201",
"EnumerationDate": "04/20/2010",
"LastUpdateDate": "04/20/2010",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "HUTCHISON",
"AuthorizedOfficialFirstName": "BOBBIE",
"AuthorizedOfficialMiddleName": null,
"AuthorizedOfficialTitle": "OWNER",
"AuthorizedOfficialNamePrefix": null,
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "DC",
"AuthorizedOfficialTelephoneNumber": "972-578-2225",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "111N00000X",
"TaxonomyName": "Chiropractor",
"LicenseNumber": "11162",
"LicenseNumberStateCode": "TX",
"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."
}
}
}
}