{
"Npi": {
"NPI": "1518361989",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "Y",
"ParentOrgLBN": "U.S. RENAL CARE, INC.",
"ParentOrgTIN": null,
"OrgName": "USRC WINDER, LLC",
"LastName": null,
"FirstName": null,
"MiddleName": null,
"NamePrefix": null,
"NameSuffix": null,
"Credential": null,
"OtherOrgName": null,
"OtherOrgNameTypeCode": "6",
"OtherLastName": null,
"OtherFirstName": null,
"OtherMiddleName": null,
"OtherNamePrefix": null,
"OtherNameSuffix": null,
"OtherCredential": null,
"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "PO BOX 844631",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "DALLAS",
"MailingAddressStateName": "TX",
"MailingAddressPostalCode": "75284-4631",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "214-736-2700",
"MailingAddressFaxNumber": "214-736-2690",
"FirstLinePracticeLocationAddress": "429 LOGANVILLE HWY STE 105-109",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "WINDER",
"PracticeLocationAddressStateName": "GA",
"PracticeLocationAddressPostalCode": "30680",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "678-425-9568",
"PracticeLocationAddressFaxNumber": "678-963-0499",
"EnumerationDate": "10/14/2014",
"LastUpdateDate": "07/11/2018",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "WEINBERG",
"AuthorizedOfficialFirstName": "THOMAS",
"AuthorizedOfficialMiddleName": "L",
"AuthorizedOfficialTitle": "SENIOR VICE PRESIDENT",
"AuthorizedOfficialNamePrefix": null,
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": null,
"AuthorizedOfficialTelephoneNumber": "214-736-2700",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "261QE0700X",
"TaxonomyName": "End-Stage Renal Disease (ESRD) Treatment Clinic/Center",
"LicenseNumber": null,
"LicenseNumberStateCode": null,
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}