{
"Npi": {
"NPI": "1457864944",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "MCCLAY HEALTH AND REHAB LLC",
"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": "3801 MCCLAY ROAD",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "ST. PETERS",
"MailingAddressStateName": "MO",
"MailingAddressPostalCode": "63376",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "636-244-3323",
"MailingAddressFaxNumber": "636-317-1881",
"FirstLinePracticeLocationAddress": "3801 MCCLAY RD",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "SAINT PETERS",
"PracticeLocationAddressStateName": "MO",
"PracticeLocationAddressPostalCode": "63376-7327",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "636-244-3323",
"PracticeLocationAddressFaxNumber": null,
"EnumerationDate": "11/07/2017",
"LastUpdateDate": "08/05/2022",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "JACKSON",
"AuthorizedOfficialFirstName": "MARY",
"AuthorizedOfficialMiddleName": "J",
"AuthorizedOfficialTitle": "CFO",
"AuthorizedOfficialNamePrefix": null,
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": null,
"AuthorizedOfficialTelephoneNumber": "636-284-7377",
"Taxonomies": {
"Taxonomy": [
{
"TaxonomyCode": "273Y00000X",
"TaxonomyName": "Rehabilitation Hospital Unit",
"LicenseNumber": null,
"LicenseNumberStateCode": null,
"PrimaryTaxonomySwitch": "N"
},
{
"TaxonomyCode": "275N00000X",
"TaxonomyName": "Medicare Defined Swing Bed Hospital Unit",
"LicenseNumber": null,
"LicenseNumberStateCode": null,
"PrimaryTaxonomySwitch": "N"
},
{
"TaxonomyCode": "332BN1400X",
"TaxonomyName": "Nursing Facility Supplies (DME)",
"LicenseNumber": null,
"LicenseNumberStateCode": null,
"PrimaryTaxonomySwitch": "N"
},
{
"TaxonomyCode": "314000000X",
"TaxonomyName": "Skilled Nursing Facility",
"LicenseNumber": null,
"LicenseNumberStateCode": null,
"PrimaryTaxonomySwitch": "Y"
}
]
},
"HealthcareProviderTaxonomyGroups": null
}
}