{
"Npi": {
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"EIN": null,
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"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "LIFE BRIDGE HEALTH",
"LastName": null,
"FirstName": null,
"MiddleName": null,
"NamePrefix": null,
"NameSuffix": null,
"Credential": null,
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"OtherLastName": null,
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"OtherCredential": null,
"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "1909 OLIVINE CT",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "SILVER SPRING",
"MailingAddressStateName": "MD",
"MailingAddressPostalCode": "20904-5323",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "240-476-1069",
"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "1909 OLIVINE CT",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "SILVER SPRING",
"PracticeLocationAddressStateName": "MD",
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"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "240-476-1069",
"PracticeLocationAddressFaxNumber": null,
"EnumerationDate": "01/21/2014",
"LastUpdateDate": "01/21/2014",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "TAMERAT",
"AuthorizedOfficialFirstName": "DANIEL",
"AuthorizedOfficialMiddleName": "TSIGE",
"AuthorizedOfficialTitle": "PA-C",
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"AuthorizedOfficialCredential": null,
"AuthorizedOfficialTelephoneNumber": "240-476-1069",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "282E00000X",
"TaxonomyName": "Long Term Care Hospital",
"LicenseNumber": "C0005298",
"LicenseNumberStateCode": "MD",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}