{
"Npi": {
"NPI": "1356927594",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "COMMUNITY OF HOPE HEALTH CLINIC- A VOLUNTEERS IN MEDICINE CLINIC",
"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 177",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "PELHAM",
"MailingAddressStateName": "AL",
"MailingAddressPostalCode": "35124-0177",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "205-644-8641",
"MailingAddressFaxNumber": "205-574-3128",
"FirstLinePracticeLocationAddress": "2692 PELHAM PKWY STE E",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "PELHAM",
"PracticeLocationAddressStateName": "AL",
"PracticeLocationAddressPostalCode": "35124-1337",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "205-644-8640",
"PracticeLocationAddressFaxNumber": null,
"EnumerationDate": "03/18/2021",
"LastUpdateDate": "09/03/2021",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "JOHNSTON",
"AuthorizedOfficialFirstName": "JUSTIN",
"AuthorizedOfficialMiddleName": "ROYCE",
"AuthorizedOfficialTitle": "EXECUTIVE DIRECTOR",
"AuthorizedOfficialNamePrefix": null,
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": null,
"AuthorizedOfficialTelephoneNumber": "205-644-8641",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "261QC1500X",
"TaxonomyName": "Community Health Clinic/Center",
"LicenseNumber": null,
"LicenseNumberStateCode": null,
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}