{
"Npi": {
"NPI": "1497550677",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "SPERRY HEALTH 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": "418 BROADWAY # 5931",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "ALBANY",
"MailingAddressStateName": "NY",
"MailingAddressPostalCode": "12207-2922",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "888-711-8630",
"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "418 BROADWAY # 5931",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "ALBANY",
"PracticeLocationAddressStateName": "NY",
"PracticeLocationAddressPostalCode": "12207-2922",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "888-711-8630",
"PracticeLocationAddressFaxNumber": null,
"EnumerationDate": "02/13/2025",
"LastUpdateDate": "04/22/2025",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "NICHOLS",
"AuthorizedOfficialFirstName": "JASON",
"AuthorizedOfficialMiddleName": null,
"AuthorizedOfficialTitle": "MEMBER",
"AuthorizedOfficialNamePrefix": null,
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "RN",
"AuthorizedOfficialTelephoneNumber": "888-711-8630",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "261Q00000X",
"TaxonomyName": "Clinic/Center",
"LicenseNumber": null,
"LicenseNumberStateCode": null,
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}