{
"Npi": {
"NPI": "1578763579",
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"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
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"OrgName": "ADVANCED ORTHOTICS AND PROSTHETICS TECHNOLOGIES LLC",
"LastName": null,
"FirstName": null,
"MiddleName": null,
"NamePrefix": null,
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"OtherCredential": null,
"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "12 FAWN RIDGE DR",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "BROOKFIELD",
"MailingAddressStateName": "CT",
"MailingAddressPostalCode": "06804-3803",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "203-740-8952",
"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "133-135 SOUTH ST.",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "DANBURY",
"PracticeLocationAddressStateName": "CT",
"PracticeLocationAddressPostalCode": "06810",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "203-798-7616",
"PracticeLocationAddressFaxNumber": null,
"EnumerationDate": "07/19/2007",
"LastUpdateDate": "07/27/2007",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "VAN HOOF",
"AuthorizedOfficialFirstName": "GREGORY",
"AuthorizedOfficialMiddleName": "MICHAEL",
"AuthorizedOfficialTitle": "OWNER",
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"AuthorizedOfficialNameSuffix": "II",
"AuthorizedOfficialCredential": "C.P.O.",
"AuthorizedOfficialTelephoneNumber": "203-740-8952",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "335E00000X",
"TaxonomyName": "Prosthetic/Orthotic Supplier",
"LicenseNumber": "CPO 1530",
"LicenseNumberStateCode": "CT",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}