{
"Npi": {
"NPI": "1568283109",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "MCPHERSON MEDICAL & DIAGNOSTIC, LLC",
"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": "901 W COMMERCIAL ST",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "KENNETT",
"MailingAddressStateName": "MO",
"MailingAddressPostalCode": "63857-1100",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "573-717-1072",
"MailingAddressFaxNumber": "573-658-1876",
"FirstLinePracticeLocationAddress": "16922 TELGE RD STE 2G",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "CYPRESS",
"PracticeLocationAddressStateName": "TX",
"PracticeLocationAddressPostalCode": "77429-1108",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "573-559-3591",
"PracticeLocationAddressFaxNumber": "573-658-1876",
"EnumerationDate": "10/17/2024",
"LastUpdateDate": "10/17/2024",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "ARSHAD",
"AuthorizedOfficialFirstName": "ABDULLAH",
"AuthorizedOfficialMiddleName": null,
"AuthorizedOfficialTitle": "MD",
"AuthorizedOfficialNamePrefix": null,
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": null,
"AuthorizedOfficialTelephoneNumber": "573-724-0083",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "291U00000X",
"TaxonomyName": "Clinical Medical Laboratory",
"LicenseNumber": null,
"LicenseNumberStateCode": null,
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}