{
"Npi": {
"NPI": "1346476777",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "KORMICK HOME CARE",
"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": "11380 SOUTHBRIDGE PKWY",
"SecondLineMailingAddress": "SUITE 225",
"MailingAddressCityName": "ALPHARETTA",
"MailingAddressStateName": "GA",
"MailingAddressPostalCode": "30022-4433",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "770-777-4781",
"MailingAddressFaxNumber": "770-777-4782",
"FirstLinePracticeLocationAddress": "11380 SOUTHBRIDGE PKWY",
"SecondLinePracticeLocationAddress": "SUITE 225",
"PracticeLocationAddressCityName": "ALPHARETTA",
"PracticeLocationAddressStateName": "GA",
"PracticeLocationAddressPostalCode": "30022-4433",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "770-777-4781",
"PracticeLocationAddressFaxNumber": "770-777-4782",
"EnumerationDate": "05/29/2009",
"LastUpdateDate": "05/29/2009",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "MCCORMICK",
"AuthorizedOfficialFirstName": "SUE",
"AuthorizedOfficialMiddleName": "P",
"AuthorizedOfficialTitle": "OWNER",
"AuthorizedOfficialNamePrefix": "MRS.",
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": null,
"AuthorizedOfficialTelephoneNumber": "770-777-4781",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "253Z00000X",
"TaxonomyName": "In Home Supportive Care Agency",
"LicenseNumber": "060-R-0508",
"LicenseNumberStateCode": "GA",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}