{
"Npi": {
"NPI": "1316013204",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "INTERACTIVE PHYSICAL THERAPY LLC",
"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": "3405 NW HUNTERS RIDGE TER STE 300",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "TOPEKA",
"MailingAddressStateName": "KS",
"MailingAddressPostalCode": "66618-2510",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "785-246-2300",
"MailingAddressFaxNumber": "785-246-2301",
"FirstLinePracticeLocationAddress": "4745 NW HUNTERS RIDGE CIR STE D",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "TOPEKA",
"PracticeLocationAddressStateName": "KS",
"PracticeLocationAddressPostalCode": "66618-2538",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "785-246-2300",
"PracticeLocationAddressFaxNumber": "785-246-2301",
"EnumerationDate": "11/24/2006",
"LastUpdateDate": "11/21/2013",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "BAIRD",
"AuthorizedOfficialFirstName": "RIC",
"AuthorizedOfficialMiddleName": "A",
"AuthorizedOfficialTitle": "OWNER",
"AuthorizedOfficialNamePrefix": "MR.",
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "PT",
"AuthorizedOfficialTelephoneNumber": "785-246-2300",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "261QP2000X",
"TaxonomyName": "Physical Therapy Clinic/Center",
"LicenseNumber": "11-02038",
"LicenseNumberStateCode": "KS",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}