{
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"EIN": null,
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"IsOrgSubpart": "N",
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"OrgName": "RALEIGH ORTHOPEDIC CENTER PLLC",
"LastName": null,
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"NamePrefix": null,
"NameSuffix": null,
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"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "PO BOX 810",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "WHITE SULPHUR SPRINGS",
"MailingAddressStateName": "WV",
"MailingAddressPostalCode": "24986-0810",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "304-536-5030",
"MailingAddressFaxNumber": "304-536-5031",
"FirstLinePracticeLocationAddress": "1007 S OAKWOOD AVE",
"SecondLinePracticeLocationAddress": "SUITE 102",
"PracticeLocationAddressCityName": "BECKLEY",
"PracticeLocationAddressStateName": "WV",
"PracticeLocationAddressPostalCode": "25801-5935",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "304-255-3150",
"PracticeLocationAddressFaxNumber": "304-255-3151",
"EnumerationDate": "06/11/2007",
"LastUpdateDate": "02/18/2009",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "SCIBETTA",
"AuthorizedOfficialFirstName": "PAUL",
"AuthorizedOfficialMiddleName": "J.",
"AuthorizedOfficialTitle": "OWNER",
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"AuthorizedOfficialNameSuffix": "JR.",
"AuthorizedOfficialCredential": "DO",
"AuthorizedOfficialTelephoneNumber": "304-255-3150",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "207X00000X",
"TaxonomyName": "Orthopaedic Surgery Physician",
"LicenseNumber": "2232",
"LicenseNumberStateCode": "WV",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": {
"HealthcareProviderTaxonomyGroup": {
"HealthcareProviderTaxonomyGroupName": "193400000X SINGLE SPECIALTY GROUP",
"HealthcareProviderTaxonomyGroupDescription": "Single Specialty Group - A business group of one or more individual practitioners, all of who practice with the same area of specialization."
}
}
}
}