{
"Npi": {
"NPI": "1457801946",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "AUDIO HEARING CENTER",
"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": "1306 BROADWAY ST",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "MOUNT VERNON",
"MailingAddressStateName": "IL",
"MailingAddressPostalCode": "62864-3717",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "618-242-1126",
"MailingAddressFaxNumber": "618-242-5296",
"FirstLinePracticeLocationAddress": "1306 BROADWAY ST",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "MOUNT VERNON",
"PracticeLocationAddressStateName": "IL",
"PracticeLocationAddressPostalCode": "62864-3717",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "618-242-1126",
"PracticeLocationAddressFaxNumber": "618-242-5296",
"EnumerationDate": "10/07/2016",
"LastUpdateDate": "10/07/2016",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "STEPHENS",
"AuthorizedOfficialFirstName": "MARTIN",
"AuthorizedOfficialMiddleName": "JAY",
"AuthorizedOfficialTitle": "HEARING INSTRUMENT SPECIALIST",
"AuthorizedOfficialNamePrefix": "MR.",
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "BC-HIS",
"AuthorizedOfficialTelephoneNumber": "618-242-1126",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "332S00000X",
"TaxonomyName": "Hearing Aid Equipment",
"LicenseNumber": "2234",
"LicenseNumberStateCode": "IL",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}