{
"Npi": {
"NPI": "1295063626",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "PLYMOUTH CARVER PRIMARY CARE",
"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": "110 LONG POND RD",
"SecondLineMailingAddress": "SUITE 212",
"MailingAddressCityName": "PLYMOUTH",
"MailingAddressStateName": "MA",
"MailingAddressPostalCode": "02360-2642",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "508-746-7272",
"MailingAddressFaxNumber": "508-746-0104",
"FirstLinePracticeLocationAddress": "110 LONG POND RD",
"SecondLinePracticeLocationAddress": "SUITE 212",
"PracticeLocationAddressCityName": "PLYMOUTH",
"PracticeLocationAddressStateName": "MA",
"PracticeLocationAddressPostalCode": "02360-2642",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "508-746-7272",
"PracticeLocationAddressFaxNumber": "508-746-0104",
"EnumerationDate": "11/23/2009",
"LastUpdateDate": "11/23/2009",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "CONWAY",
"AuthorizedOfficialFirstName": "HEATHER",
"AuthorizedOfficialMiddleName": "JANE",
"AuthorizedOfficialTitle": "NURSE PRACTITIONER",
"AuthorizedOfficialNamePrefix": "MRS.",
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "ANP- BC",
"AuthorizedOfficialTelephoneNumber": "508-746-7272",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "261QM1300X",
"TaxonomyName": "Multi-Specialty Clinic/Center",
"LicenseNumber": null,
"LicenseNumberStateCode": null,
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}