{
"Npi": {
"NPI": "1447489695",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "AMBULATORY SURGERY CENTER AT VIRTUA WASHINGTON TOWNSHIP, L.L.C.",
"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": "11641 CHARLES CT",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "FARMINGTON",
"MailingAddressStateName": "AR",
"MailingAddressPostalCode": "72730-8782",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "479-267-2756",
"MailingAddressFaxNumber": "479-267-2757",
"FirstLinePracticeLocationAddress": "239 HURFFVILLE CROSSKEYS RD",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "SEWELL",
"PracticeLocationAddressStateName": "NJ",
"PracticeLocationAddressPostalCode": "08080-4001",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "479-267-2756",
"PracticeLocationAddressFaxNumber": null,
"EnumerationDate": "07/09/2009",
"LastUpdateDate": "11/23/2009",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "STINCHCOMB",
"AuthorizedOfficialFirstName": "DEBRA",
"AuthorizedOfficialMiddleName": null,
"AuthorizedOfficialTitle": "MANAGER",
"AuthorizedOfficialNamePrefix": null,
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "RN, BSN, CASC",
"AuthorizedOfficialTelephoneNumber": "479-267-2756",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "261QA1903X",
"TaxonomyName": "Ambulatory Surgical Clinic/Center",
"LicenseNumber": null,
"LicenseNumberStateCode": "NJ",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}