{
"Npi": {
"NPI": "1447358965",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "OSAGE NURSING CENTER, LLC",
"LastName": null,
"FirstName": null,
"MiddleName": null,
"NamePrefix": null,
"NameSuffix": null,
"Credential": null,
"OtherOrgName": null,
"OtherOrgNameTypeCode": null,
"OtherLastName": null,
"OtherFirstName": null,
"OtherMiddleName": null,
"OtherNamePrefix": null,
"OtherNameSuffix": null,
"OtherCredential": null,
"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "PO BOX 429",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "SALLISAW",
"MailingAddressStateName": "OK",
"MailingAddressPostalCode": "74955-0429",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "918-775-4439",
"MailingAddressFaxNumber": "918-775-9242",
"FirstLinePracticeLocationAddress": "822 W OSAGE AVE",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "NOWATA",
"PracticeLocationAddressStateName": "OK",
"PracticeLocationAddressPostalCode": "74048-3317",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "918-273-2012",
"PracticeLocationAddressFaxNumber": "918-273-3631",
"EnumerationDate": "09/20/2006",
"LastUpdateDate": "05/15/2012",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "MCGREW",
"AuthorizedOfficialFirstName": "JUSTIN",
"AuthorizedOfficialMiddleName": null,
"AuthorizedOfficialTitle": "MEMBER",
"AuthorizedOfficialNamePrefix": "MR.",
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": null,
"AuthorizedOfficialTelephoneNumber": "918-775-4439",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "313M00000X",
"TaxonomyName": "Nursing Facility/Intermediate Care Facility",
"LicenseNumber": "NH5303-5303",
"LicenseNumberStateCode": "OK",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}