{
"Npi": {
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"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "Y",
"ParentOrgLBN": "TRINITY HEALTH PACE",
"ParentOrgTIN": null,
"OrgName": "TRINITY HEALTH PACE OF PENSACOLA INC",
"LastName": null,
"FirstName": null,
"MiddleName": null,
"NamePrefix": null,
"NameSuffix": null,
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"OtherOrgName": null,
"OtherOrgNameTypeCode": null,
"OtherLastName": null,
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"OtherNamePrefix": null,
"OtherNameSuffix": null,
"OtherCredential": null,
"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "5020 COMMERCE PARK CIR",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "PENSACOLA",
"MailingAddressStateName": "FL",
"MailingAddressPostalCode": "32505-1869",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "850-806-0900",
"MailingAddressFaxNumber": "850-806-0901",
"FirstLinePracticeLocationAddress": "5020 COMMERCE PARK CIR",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "PENSACOLA",
"PracticeLocationAddressStateName": "FL",
"PracticeLocationAddressPostalCode": "32505-1869",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "850-806-0900",
"PracticeLocationAddressFaxNumber": "850-806-0901",
"EnumerationDate": "05/04/2023",
"LastUpdateDate": "05/05/2023",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "GARRETT",
"AuthorizedOfficialFirstName": "TRAVIS",
"AuthorizedOfficialMiddleName": null,
"AuthorizedOfficialTitle": "EXECUTIVE DIRECTOR",
"AuthorizedOfficialNamePrefix": null,
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "MBA, BSN, RN",
"AuthorizedOfficialTelephoneNumber": "850-806-0830",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "251T00000X",
"TaxonomyName": "PACE Provider Organization",
"LicenseNumber": null,
"LicenseNumberStateCode": null,
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}