{
"Npi": {
"NPI": "1346507209",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "JOANNA LYNN RILEY",
"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": "PO BOX 14774",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "ODESSA",
"MailingAddressStateName": "TX",
"MailingAddressPostalCode": "79768-4774",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "432-638-4544",
"MailingAddressFaxNumber": "432-362-1449",
"FirstLinePracticeLocationAddress": "2760 N GRANDVIEW AVE",
"SecondLinePracticeLocationAddress": "SUITE A",
"PracticeLocationAddressCityName": "ODESSA",
"PracticeLocationAddressStateName": "TX",
"PracticeLocationAddressPostalCode": "79762-6953",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "432-552-7034",
"PracticeLocationAddressFaxNumber": "432-552-7165",
"EnumerationDate": "04/17/2012",
"LastUpdateDate": "09/14/2012",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "RILEY",
"AuthorizedOfficialFirstName": "JOANNA",
"AuthorizedOfficialMiddleName": null,
"AuthorizedOfficialTitle": "OWNER",
"AuthorizedOfficialNamePrefix": "MS.",
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "LOT",
"AuthorizedOfficialTelephoneNumber": "432-638-4544",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "261QM1300X",
"TaxonomyName": "Multi-Specialty Clinic/Center",
"LicenseNumber": "109122",
"LicenseNumberStateCode": "TX",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}