{
"Npi": {
"NPI": "1447731492",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "KINGSPORT FAMILY RECOVERY ASSOCIATES",
"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 2061",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "KINGSPORT",
"MailingAddressStateName": "TN",
"MailingAddressPostalCode": "37662-2061",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "423-288-0223",
"MailingAddressFaxNumber": "423-288-0220",
"FirstLinePracticeLocationAddress": "1729 LYNN GARDEN DR",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "KINGSPORT",
"PracticeLocationAddressStateName": "TN",
"PracticeLocationAddressPostalCode": "37665-1365",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "423-288-0223",
"PracticeLocationAddressFaxNumber": "423-288-0220",
"EnumerationDate": "08/28/2018",
"LastUpdateDate": "08/28/2018",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "NEUBERT",
"AuthorizedOfficialFirstName": "RICHARD",
"AuthorizedOfficialMiddleName": null,
"AuthorizedOfficialTitle": "OWNER & MEDICAL DIRECTOR",
"AuthorizedOfficialNamePrefix": "DR.",
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "MD",
"AuthorizedOfficialTelephoneNumber": "423-741-8415",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "261QR0800X",
"TaxonomyName": "Recovery Care Clinic/Center",
"LicenseNumber": "MD0000040883",
"LicenseNumberStateCode": "TN",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}