{
"Npi": {
"NPI": "1518316272",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "JOHNSON FAMILY CHIROPRACTIC CLINIC",
"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": "11914 N PENNSYLVANIA AVE",
"SecondLineMailingAddress": "SUITE B3",
"MailingAddressCityName": "OKLAHOMA CITY",
"MailingAddressStateName": "OK",
"MailingAddressPostalCode": "73120-7831",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "405-752-8819",
"MailingAddressFaxNumber": "405-751-1238",
"FirstLinePracticeLocationAddress": "11914 N PENNSYLVANIA AVE",
"SecondLinePracticeLocationAddress": "SUITE B3",
"PracticeLocationAddressCityName": "OKLAHOMA CITY",
"PracticeLocationAddressStateName": "OK",
"PracticeLocationAddressPostalCode": "73120-7831",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "405-752-8819",
"PracticeLocationAddressFaxNumber": "405-751-1238",
"EnumerationDate": "06/03/2016",
"LastUpdateDate": "06/03/2016",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "JOHNSON",
"AuthorizedOfficialFirstName": "JERRY",
"AuthorizedOfficialMiddleName": "LEE",
"AuthorizedOfficialTitle": "DOCTOR",
"AuthorizedOfficialNamePrefix": null,
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "DC",
"AuthorizedOfficialTelephoneNumber": "405-752-8819",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "305R00000X",
"TaxonomyName": "Preferred Provider Organization",
"LicenseNumber": "2626",
"LicenseNumberStateCode": "OK",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}