{
"Npi": {
"NPI": "1366984122",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "TED H. BRADY,D.O.,PA",
"LastName": null,
"FirstName": null,
"MiddleName": null,
"NamePrefix": null,
"NameSuffix": null,
"Credential": null,
"OtherOrgName": null,
"OtherOrgNameTypeCode": "6",
"OtherLastName": null,
"OtherFirstName": null,
"OtherMiddleName": null,
"OtherNamePrefix": null,
"OtherNameSuffix": null,
"OtherCredential": null,
"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "7710 NW 71ST CT",
"SecondLineMailingAddress": "STE 203",
"MailingAddressCityName": "TAMARAC",
"MailingAddressStateName": "FL",
"MailingAddressPostalCode": "33321-2973",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "954-721-3008",
"MailingAddressFaxNumber": "954-721-3088",
"FirstLinePracticeLocationAddress": "7710 NW 71ST CT",
"SecondLinePracticeLocationAddress": "STE 203",
"PracticeLocationAddressCityName": "TAMARAC",
"PracticeLocationAddressStateName": "FL",
"PracticeLocationAddressPostalCode": "33321-2973",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "954-721-3008",
"PracticeLocationAddressFaxNumber": "954-721-3088",
"EnumerationDate": "11/10/2016",
"LastUpdateDate": "11/10/2016",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "BRADY",
"AuthorizedOfficialFirstName": "TED",
"AuthorizedOfficialMiddleName": "HUGH",
"AuthorizedOfficialTitle": "OWNER",
"AuthorizedOfficialNamePrefix": "DR.",
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "D.O.",
"AuthorizedOfficialTelephoneNumber": "954-721-3008",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "207RP1001X",
"TaxonomyName": "Pulmonary Disease Physician",
"LicenseNumber": "OS5247",
"LicenseNumberStateCode": "FL",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": {
"HealthcareProviderTaxonomyGroup": {
"HealthcareProviderTaxonomyGroupName": "193400000X SINGLE SPECIALTY GROUP",
"HealthcareProviderTaxonomyGroupDescription": "Single Specialty Group - A business group of one or more individual practitioners, all of who practice with the same area of specialization."
}
}
}
}