{
"Npi": {
"NPI": "1316337637",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "THERAPAEDIC PHYSICAL THERAPY",
"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": "2621 CROSSVINE DR",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "DUMFRIES",
"MailingAddressStateName": "VA",
"MailingAddressPostalCode": "22026-3053",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "404-441-3289",
"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "5800 MAPLEDALE PLZ",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "WOODBRIDGE",
"PracticeLocationAddressStateName": "VA",
"PracticeLocationAddressPostalCode": "22193-4535",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "703-680-3332",
"PracticeLocationAddressFaxNumber": "703-680-1365",
"EnumerationDate": "01/26/2015",
"LastUpdateDate": "11/17/2022",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "ANDERSON",
"AuthorizedOfficialFirstName": "LINDSEY",
"AuthorizedOfficialMiddleName": null,
"AuthorizedOfficialTitle": "OWNER",
"AuthorizedOfficialNamePrefix": "MRS.",
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "DPT",
"AuthorizedOfficialTelephoneNumber": "404-441-3289",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "261QP2000X",
"TaxonomyName": "Physical Therapy Clinic/Center",
"LicenseNumber": "009844",
"LicenseNumberStateCode": "GA",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}