{
"Npi": {
"NPI": "1417384405",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "NDS II, LLC",
"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": "1000 E RUTHERFORD ST",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "LANDRUM",
"MailingAddressStateName": "SC",
"MailingAddressPostalCode": "29356-1727",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "843-757-2828",
"MailingAddressFaxNumber": "843-757-0595",
"FirstLinePracticeLocationAddress": "216 S MOUNTAIN ST",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "UNION",
"PracticeLocationAddressStateName": "SC",
"PracticeLocationAddressPostalCode": "29379-2331",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "864-427-0397",
"PracticeLocationAddressFaxNumber": "864-427-8286",
"EnumerationDate": "10/04/2013",
"LastUpdateDate": "10/04/2013",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "NEWMAN",
"AuthorizedOfficialFirstName": "BRENDA",
"AuthorizedOfficialMiddleName": "LYNN",
"AuthorizedOfficialTitle": "INSURANCE COORDINATOR",
"AuthorizedOfficialNamePrefix": null,
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": null,
"AuthorizedOfficialTelephoneNumber": "864-427-0397",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "122300000X",
"TaxonomyName": "Dentist",
"LicenseNumber": "3451",
"LicenseNumberStateCode": "SC",
"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."
}
}
}
}