{
"Npi": {
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"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "GODSPEED DME, LLC",
"LastName": null,
"FirstName": null,
"MiddleName": null,
"NamePrefix": null,
"NameSuffix": null,
"Credential": null,
"OtherOrgName": null,
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"OtherLastName": null,
"OtherFirstName": null,
"OtherMiddleName": null,
"OtherNamePrefix": null,
"OtherNameSuffix": null,
"OtherCredential": null,
"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "205 GREENTREE ST",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "LUMBERTON",
"MailingAddressStateName": "TX",
"MailingAddressPostalCode": "77657-5903",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "409-791-0087",
"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "1503 S MARGARET AVE",
"SecondLinePracticeLocationAddress": "UNIT 1 & 2",
"PracticeLocationAddressCityName": "KIRBYVILLE",
"PracticeLocationAddressStateName": "TX",
"PracticeLocationAddressPostalCode": "75956-2615",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "409-791-0087",
"PracticeLocationAddressFaxNumber": null,
"EnumerationDate": "01/24/2022",
"LastUpdateDate": "03/19/2023",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "DELARUE",
"AuthorizedOfficialFirstName": "NAKALA",
"AuthorizedOfficialMiddleName": "RANELLE",
"AuthorizedOfficialTitle": "OWNER/PRESIDENT",
"AuthorizedOfficialNamePrefix": "MRS.",
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "RCP",
"AuthorizedOfficialTelephoneNumber": "409-791-0087",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "332BX2000X",
"TaxonomyName": "Oxygen Equipment & Supplies (DME)",
"LicenseNumber": null,
"LicenseNumberStateCode": null,
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}