{
"Npi": {
"NPI": "1568558161",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "SOUTHERN MS PLANNING AND DEVELOPMENT DISTRICT",
"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": "9229 HWY 49",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "GULFPORT",
"MailingAddressStateName": "MS",
"MailingAddressPostalCode": "39503",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "228-868-2311",
"MailingAddressFaxNumber": "228-863-2550",
"FirstLinePracticeLocationAddress": "9229 HWY 49",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "GULFPORT",
"PracticeLocationAddressStateName": "MS",
"PracticeLocationAddressPostalCode": "39503",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "228-868-2311",
"PracticeLocationAddressFaxNumber": "228-868-2550",
"EnumerationDate": "10/04/2006",
"LastUpdateDate": "08/22/2020",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "WALLEY",
"AuthorizedOfficialFirstName": "DOROTHY",
"AuthorizedOfficialMiddleName": null,
"AuthorizedOfficialTitle": "MEDICAID WAIVER SUPERVISOR",
"AuthorizedOfficialNamePrefix": null,
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "RN",
"AuthorizedOfficialTelephoneNumber": "228-314-1475",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "251B00000X",
"TaxonomyName": "Case Management Agency",
"LicenseNumber": null,
"LicenseNumberStateCode": null,
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}