{
"Npi": {
"NPI": "1487466264",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "MIRACLE HILL 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": "22901 LINDEN BLVD",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "JAMAICA",
"MailingAddressStateName": "NY",
"MailingAddressPostalCode": "11411-1897",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "516-688-5217",
"MailingAddressFaxNumber": "888-615-3745",
"FirstLinePracticeLocationAddress": "70 E SUNRISE HWY",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "VALLEY STREAM",
"PracticeLocationAddressStateName": "NY",
"PracticeLocationAddressPostalCode": "11581-1240",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "516-688-5217",
"PracticeLocationAddressFaxNumber": "888-615-3745",
"EnumerationDate": "01/21/2025",
"LastUpdateDate": "10/01/2025",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "HERNANDEZ",
"AuthorizedOfficialFirstName": "MARY",
"AuthorizedOfficialMiddleName": null,
"AuthorizedOfficialTitle": "PRESIDENT",
"AuthorizedOfficialNamePrefix": "MS.",
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": null,
"AuthorizedOfficialTelephoneNumber": "917-653-0916",
"Taxonomies": {
"Taxonomy": [
{
"TaxonomyCode": "163WE0003X",
"TaxonomyName": "Emergency Registered Nurse",
"LicenseNumber": null,
"LicenseNumberStateCode": null,
"PrimaryTaxonomySwitch": "N"
},
{
"TaxonomyCode": "251E00000X",
"TaxonomyName": "Home Health Agency",
"LicenseNumber": null,
"LicenseNumberStateCode": null,
"PrimaryTaxonomySwitch": "Y"
}
]
},
"HealthcareProviderTaxonomyGroups": {
"HealthcareProviderTaxonomyGroup": {
"HealthcareProviderTaxonomyGroupName": "193200000X MULTI-SPECIALTY GROUP",
"HealthcareProviderTaxonomyGroupDescription": "Multi-Specialty Group - A business group of one or more individual practitioners, who practice with different areas of specialization."
}
}
}
}