{
"Npi": {
"NPI": "1588028591",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "PARTNERS IN HEALTH MANAGEMENT, 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": "202 WEST GORDON STREET",
"SecondLineMailingAddress": "SUITE - A",
"MailingAddressCityName": "ADEL",
"MailingAddressStateName": "GA",
"MailingAddressPostalCode": "31601-4565",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "229-474-4101",
"MailingAddressFaxNumber": "229-349-6006",
"FirstLinePracticeLocationAddress": "202 WEST GORDON STREET",
"SecondLinePracticeLocationAddress": "SUITE - A",
"PracticeLocationAddressCityName": "ADEL",
"PracticeLocationAddressStateName": "GA",
"PracticeLocationAddressPostalCode": "31601-4565",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "229-474-4101",
"PracticeLocationAddressFaxNumber": "229-349-6006",
"EnumerationDate": "04/06/2016",
"LastUpdateDate": "04/30/2024",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "HILLMON SCRUGGS",
"AuthorizedOfficialFirstName": "EBONY",
"AuthorizedOfficialMiddleName": null,
"AuthorizedOfficialTitle": "OWNER/PROVIDER",
"AuthorizedOfficialNamePrefix": null,
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "DNP, FNP-C",
"AuthorizedOfficialTelephoneNumber": "229-474-4101",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "261QH0100X",
"TaxonomyName": "Health Service Clinic/Center",
"LicenseNumber": "RN054469",
"LicenseNumberStateCode": "GA",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}