{
"Npi": {
"NPI": "1245310556",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "GNK MEDICAL SUPPLIER",
"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": "1234 MISTY LAKE CT",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "SUGAR LAND",
"MailingAddressStateName": "TX",
"MailingAddressPostalCode": "77478-5614",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "281-380-1289",
"MailingAddressFaxNumber": "713-952-7089",
"FirstLinePracticeLocationAddress": "7100 REGENCY SQUARE BLVD # 230-08",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "HOUSTON",
"PracticeLocationAddressStateName": "TX",
"PracticeLocationAddressPostalCode": "77036-3202",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "281-380-1289",
"PracticeLocationAddressFaxNumber": "713-952-7089",
"EnumerationDate": "10/17/2006",
"LastUpdateDate": "08/22/2020",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "NEBHNANI",
"AuthorizedOfficialFirstName": "KAVITA",
"AuthorizedOfficialMiddleName": "GOPE",
"AuthorizedOfficialTitle": "OWNER",
"AuthorizedOfficialNamePrefix": "MISS",
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": null,
"AuthorizedOfficialTelephoneNumber": "281-240-7919",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "332BX2000X",
"TaxonomyName": "Oxygen Equipment & Supplies (DME)",
"LicenseNumber": null,
"LicenseNumberStateCode": null,
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}