{
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"ParentOrgLBN": null,
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"OrgName": "KAREN DECKARD THERACARE PHYSICAL THERAPY",
"LastName": null,
"FirstName": null,
"MiddleName": null,
"NamePrefix": null,
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"Credential": null,
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"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "PO BOX 187",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "MAYFIELD",
"MailingAddressStateName": "KY",
"MailingAddressPostalCode": "42066-0015",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "270-251-3590",
"MailingAddressFaxNumber": "270-251-3586",
"FirstLinePracticeLocationAddress": "1111 MEDICAL CENTER CIR",
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"PracticeLocationAddressCityName": "MAYFIELD",
"PracticeLocationAddressStateName": "KY",
"PracticeLocationAddressPostalCode": "42066-1194",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "270-251-3590",
"PracticeLocationAddressFaxNumber": "270-251-3586",
"EnumerationDate": "11/30/2006",
"LastUpdateDate": "07/28/2008",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "DECKARD",
"AuthorizedOfficialFirstName": "KAREN",
"AuthorizedOfficialMiddleName": "YEVETT",
"AuthorizedOfficialTitle": "PT OWNER",
"AuthorizedOfficialNamePrefix": "MS.",
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "PT",
"AuthorizedOfficialTelephoneNumber": "270-251-3590",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "225100000X",
"TaxonomyName": "Physical Therapist",
"LicenseNumber": "002616",
"LicenseNumberStateCode": "KY",
"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."
}
}
}
}