{
"Npi": {
"NPI": "1578923983",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "Y",
"ParentOrgLBN": "ULTRAFLEX SYSTEMS, INC.",
"ParentOrgTIN": null,
"OrgName": "ULTRAFLEX SYSTEMS, INC.",
"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": "237 SOUTH ST",
"SecondLineMailingAddress": "SUITE 200",
"MailingAddressCityName": "POTTSTOWN",
"MailingAddressStateName": "PA",
"MailingAddressPostalCode": "19464-5984",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": null,
"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "1600 GOLF RD",
"SecondLinePracticeLocationAddress": "SUITE 1200",
"PracticeLocationAddressCityName": "ROLLING MEADOWS",
"PracticeLocationAddressStateName": "IL",
"PracticeLocationAddressPostalCode": "60008-4263",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "219-413-0568",
"PracticeLocationAddressFaxNumber": null,
"EnumerationDate": "02/26/2016",
"LastUpdateDate": "01/23/2018",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "HARDING",
"AuthorizedOfficialFirstName": "WILLIAM",
"AuthorizedOfficialMiddleName": null,
"AuthorizedOfficialTitle": "DIRECTOR OF COMPLIANCE",
"AuthorizedOfficialNamePrefix": null,
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": null,
"AuthorizedOfficialTelephoneNumber": "610-819-6019",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "335E00000X",
"TaxonomyName": "Prosthetic/Orthotic Supplier",
"LicenseNumber": "6000004052",
"LicenseNumberStateCode": "PA",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}