{
"Npi": {
"NPI": "1417944075",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "CHATTAHOOCHEE VALLEY HOSPITAL SOCIETY",
"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": "PO BOX 475",
"SecondLineMailingAddress": "5700 CHIPLEY VILLAGE",
"MailingAddressCityName": "PINE MOUNTAIN",
"MailingAddressStateName": "GA",
"MailingAddressPostalCode": "31822-0475",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "706-663-0988",
"MailingAddressFaxNumber": "706-663-0687",
"FirstLinePracticeLocationAddress": "US HWY 27 AND 354",
"SecondLinePracticeLocationAddress": "5700 CHIPLEY VILLAGE",
"PracticeLocationAddressCityName": "PINE MOUNTAIN",
"PracticeLocationAddressStateName": "GA",
"PracticeLocationAddressPostalCode": "31822-0475",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "706-663-0988",
"PracticeLocationAddressFaxNumber": "706-663-0687",
"EnumerationDate": "09/29/2005",
"LastUpdateDate": "08/22/2020",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "VEAL",
"AuthorizedOfficialFirstName": "DEBRA",
"AuthorizedOfficialMiddleName": "ANN",
"AuthorizedOfficialTitle": "DIRECTOR OF HOME HEALTH",
"AuthorizedOfficialNamePrefix": null,
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": null,
"AuthorizedOfficialTelephoneNumber": "334-756-1950",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "251E00000X",
"TaxonomyName": "Home Health Agency",
"LicenseNumber": "072-261-H",
"LicenseNumberStateCode": "GA",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}