{
"Npi": {
"NPI": "1285856682",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "REBOUND INC OF VA.",
"LastName": null,
"FirstName": null,
"MiddleName": null,
"NamePrefix": null,
"NameSuffix": null,
"Credential": null,
"OtherOrgName": null,
"OtherOrgNameTypeCode": "6",
"OtherLastName": null,
"OtherFirstName": null,
"OtherMiddleName": null,
"OtherNamePrefix": null,
"OtherNameSuffix": null,
"OtherCredential": null,
"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "400 GRESHAM DR",
"SecondLineMailingAddress": "MEDICAL TOWER ANNEX",
"MailingAddressCityName": "NORFOLK",
"MailingAddressStateName": "VA",
"MailingAddressPostalCode": "23507",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "757-625-0518",
"MailingAddressFaxNumber": "757-313-5103",
"FirstLinePracticeLocationAddress": "400 GRESHAM DR",
"SecondLinePracticeLocationAddress": "MEDICAL TOWER ANNEX",
"PracticeLocationAddressCityName": "NORFOLK",
"PracticeLocationAddressStateName": "VA",
"PracticeLocationAddressPostalCode": "23507",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "757-625-0518",
"PracticeLocationAddressFaxNumber": "757-313-5103",
"EnumerationDate": "05/03/2007",
"LastUpdateDate": "08/22/2020",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "FEBER",
"AuthorizedOfficialFirstName": "ROBERT",
"AuthorizedOfficialMiddleName": "JOHN",
"AuthorizedOfficialTitle": "PRESIDENT",
"AuthorizedOfficialNamePrefix": "MR.",
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "REGISTERED OPTICIAN",
"AuthorizedOfficialTelephoneNumber": "757-625-0518",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "332B00000X",
"TaxonomyName": "Durable Medical Equipment & Medical Supplies",
"LicenseNumber": "742",
"LicenseNumberStateCode": "VA",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}