{
"Npi": {
"NPI": "1518160191",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "DEPARTMENT OF VETERANS AFFAIRS",
"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": "19508 MCCRAY DR",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "ABINGDON",
"MailingAddressStateName": "VA",
"MailingAddressPostalCode": "24211-6838",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "276-676-0829",
"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "19508 MCCRAY DR",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "ABINGDON",
"PracticeLocationAddressStateName": "VA",
"PracticeLocationAddressPostalCode": "24211-6838",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "276-676-0829",
"PracticeLocationAddressFaxNumber": null,
"EnumerationDate": "06/09/2007",
"LastUpdateDate": "08/22/2020",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "HAYES",
"AuthorizedOfficialFirstName": "LINDA",
"AuthorizedOfficialMiddleName": "SUE",
"AuthorizedOfficialTitle": "REGISTERED NURSE",
"AuthorizedOfficialNamePrefix": null,
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": null,
"AuthorizedOfficialTelephoneNumber": "276-676-0829",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "313M00000X",
"TaxonomyName": "Nursing Facility/Intermediate Care Facility",
"LicenseNumber": "0001124615",
"LicenseNumberStateCode": "VA",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}