{
"Npi": {
"NPI": "1568013100",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "AMERICAN HOME HEALTH TEAM 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": "2611 JEFFERSON DAVIS HWY STE 600",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "ARLINGTON",
"MailingAddressStateName": "VA",
"MailingAddressPostalCode": "22202-4016",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "571-775-8911",
"MailingAddressFaxNumber": "703-563-9615",
"FirstLinePracticeLocationAddress": "4242 CHAIN BRIDGE RD STE B",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "FAIRFAX",
"PracticeLocationAddressStateName": "VA",
"PracticeLocationAddressPostalCode": "22030-8146",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "703-639-7888",
"PracticeLocationAddressFaxNumber": "703-995-4747",
"EnumerationDate": "09/25/2019",
"LastUpdateDate": "03/10/2022",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "MOHAMED",
"AuthorizedOfficialFirstName": "ISMAIL",
"AuthorizedOfficialMiddleName": null,
"AuthorizedOfficialTitle": "ADMINISTRATOR",
"AuthorizedOfficialNamePrefix": null,
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": null,
"AuthorizedOfficialTelephoneNumber": "703-639-7888",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "251E00000X",
"TaxonomyName": "Home Health Agency",
"LicenseNumber": null,
"LicenseNumberStateCode": null,
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}