{
"Npi": {
"NPI": "1437636222",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "HOME OF POTENTIAL AND EXCELLENCE",
"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": "4636 LEBANON PIKE # 247",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "HERMITAGE",
"MailingAddressStateName": "TN",
"MailingAddressPostalCode": "37076-1316",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "615-802-0322",
"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "2996A WINDEMERE CIRCLE",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "NASHVILLE",
"PracticeLocationAddressStateName": "TN",
"PracticeLocationAddressPostalCode": "37214",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "615-802-0322",
"PracticeLocationAddressFaxNumber": null,
"EnumerationDate": "07/24/2018",
"LastUpdateDate": "07/24/2018",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "ADAMS",
"AuthorizedOfficialFirstName": "SHEMICKA",
"AuthorizedOfficialMiddleName": null,
"AuthorizedOfficialTitle": "EXECUTIVE DIRECTOR",
"AuthorizedOfficialNamePrefix": null,
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "LBA, BCBA",
"AuthorizedOfficialTelephoneNumber": "615-802-0322",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "103K00000X",
"TaxonomyName": "Behavior Analyst",
"LicenseNumber": "1-1624755",
"LicenseNumberStateCode": "TN",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": {
"HealthcareProviderTaxonomyGroup": {
"HealthcareProviderTaxonomyGroupName": "193400000X MULTIPLE 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."
}
}
}
}