{
"Npi": {
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"EIN": null,
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"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "BETHESDA ENT ALLERGY CENTER, LLC",
"LastName": null,
"FirstName": null,
"MiddleName": null,
"NamePrefix": null,
"NameSuffix": null,
"Credential": null,
"OtherOrgName": null,
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"OtherCredential": null,
"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "4550 MONTGOMERY AVE",
"SecondLineMailingAddress": "SUITE 733N",
"MailingAddressCityName": "BETHESDA",
"MailingAddressStateName": "MD",
"MailingAddressPostalCode": "20814-3304",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "301-656-6452",
"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "4550 MONTGOMERY AVE",
"SecondLinePracticeLocationAddress": "SUITE 733N",
"PracticeLocationAddressCityName": "BETHESDA",
"PracticeLocationAddressStateName": "MD",
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"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "301-656-6452",
"PracticeLocationAddressFaxNumber": null,
"EnumerationDate": "03/05/2007",
"LastUpdateDate": "08/22/2020",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "PIEPERGERDES",
"AuthorizedOfficialFirstName": "JAMES",
"AuthorizedOfficialMiddleName": "C.",
"AuthorizedOfficialTitle": "MANAGER",
"AuthorizedOfficialNamePrefix": "DR.",
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "MD",
"AuthorizedOfficialTelephoneNumber": "202-360-0525",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "261QM2500X",
"TaxonomyName": "Medical Specialty Clinic/Center",
"LicenseNumber": "D0043074",
"LicenseNumberStateCode": "MD",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}