{
"Npi": {
"NPI": "1356768907",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "WOUND CARE PARTNERS, 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": "304 W SIERRA MADRE BLVD",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "SIERRA MADRE",
"MailingAddressStateName": "CA",
"MailingAddressPostalCode": "91024-2313",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": null,
"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "304 W SIERRA MADRE BLVD",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "SIERRA MADRE",
"PracticeLocationAddressStateName": "CA",
"PracticeLocationAddressPostalCode": "91024-2313",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "888-794-2362",
"PracticeLocationAddressFaxNumber": null,
"EnumerationDate": "03/20/2014",
"LastUpdateDate": "03/20/2014",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "WOOD",
"AuthorizedOfficialFirstName": "CONNIE",
"AuthorizedOfficialMiddleName": null,
"AuthorizedOfficialTitle": "GENERAL COUNSEL",
"AuthorizedOfficialNamePrefix": null,
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "ESQ.",
"AuthorizedOfficialTelephoneNumber": "888-484-3922",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "261Q00000X",
"TaxonomyName": "Clinic/Center",
"LicenseNumber": null,
"LicenseNumberStateCode": null,
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}