{
"Npi": {
"NPI": "1497270763",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "Y",
"ParentOrgLBN": "THE NEST BIRTH CENTER, PLLC",
"ParentOrgTIN": null,
"OrgName": "THE NEST BIRTH CENTER, PLLC",
"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": "208 E. BROAD STREET",
"SecondLineMailingAddress": "104",
"MailingAddressCityName": "MANSFIELD",
"MailingAddressStateName": "TX",
"MailingAddressPostalCode": "76063-1790",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "817-691-0856",
"MailingAddressFaxNumber": "817-691-0856",
"FirstLinePracticeLocationAddress": "208 E BROAD ST",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "MANSFIELD",
"PracticeLocationAddressStateName": "TX",
"PracticeLocationAddressPostalCode": "76063-7703",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "817-691-0856",
"PracticeLocationAddressFaxNumber": "817-549-2575",
"EnumerationDate": "08/08/2017",
"LastUpdateDate": "07/21/2022",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "RIELL",
"AuthorizedOfficialFirstName": "LISA",
"AuthorizedOfficialMiddleName": "M.",
"AuthorizedOfficialTitle": "OWNER",
"AuthorizedOfficialNamePrefix": "MS.",
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "CPM, LM",
"AuthorizedOfficialTelephoneNumber": "817-691-0856",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "261QB0400X",
"TaxonomyName": "Birthing Clinic/Center",
"LicenseNumber": "999233",
"LicenseNumberStateCode": "TX",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}