{
"Npi": {
"NPI": "1366899205",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "NEXT LEVEL HOME THERAPY SERVICES",
"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": "9760 MANDON RD",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "WHITE LAKE",
"MailingAddressStateName": "MI",
"MailingAddressPostalCode": "48386-2949",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "248-388-1362",
"MailingAddressFaxNumber": "810-720-6389",
"FirstLinePracticeLocationAddress": "9760 MANDON RD",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "WHITE LAKE",
"PracticeLocationAddressStateName": "MI",
"PracticeLocationAddressPostalCode": "48386-2949",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "248-388-1362",
"PracticeLocationAddressFaxNumber": "810-720-6389",
"EnumerationDate": "05/20/2016",
"LastUpdateDate": "05/20/2016",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "HEILMAN",
"AuthorizedOfficialFirstName": "DANDRA",
"AuthorizedOfficialMiddleName": "L",
"AuthorizedOfficialTitle": "OWNER",
"AuthorizedOfficialNamePrefix": null,
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": null,
"AuthorizedOfficialTelephoneNumber": "248-388-1362",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "225100000X",
"TaxonomyName": "Physical Therapist",
"LicenseNumber": "5501016732",
"LicenseNumberStateCode": "MI",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": {
"HealthcareProviderTaxonomyGroup": {
"HealthcareProviderTaxonomyGroupName": "193200000X MULTI-SPECIALTY GROUP",
"HealthcareProviderTaxonomyGroupDescription": "Multi-Specialty Group - A business group of one or more individual practitioners, who practice with different areas of specialization."
}
}
}
}