{
"Npi": {
"NPI": "1588682447",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "STATE OF SOUTH CAROLINA",
"LastName": null,
"FirstName": null,
"MiddleName": null,
"NamePrefix": null,
"NameSuffix": null,
"Credential": null,
"OtherOrgName": null,
"OtherOrgNameTypeCode": "6",
"OtherLastName": null,
"OtherFirstName": null,
"OtherMiddleName": null,
"OtherNamePrefix": null,
"OtherNameSuffix": null,
"OtherCredential": null,
"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "219 S LEMACKS ST",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "WALTERBORO",
"MailingAddressStateName": "SC",
"MailingAddressPostalCode": "29488-4374",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "843-525-5917",
"MailingAddressFaxNumber": "843-521-7621",
"FirstLinePracticeLocationAddress": "219 S LEMACKS ST",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "WALTERBORO",
"PracticeLocationAddressStateName": "SC",
"PracticeLocationAddressPostalCode": "29488-4374",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "843-525-5917",
"PracticeLocationAddressFaxNumber": "843-521-7621",
"EnumerationDate": "07/18/2006",
"LastUpdateDate": "07/11/2013",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "KIRKPATRICK",
"AuthorizedOfficialFirstName": "LEE",
"AuthorizedOfficialMiddleName": "A",
"AuthorizedOfficialTitle": "DIRECTOR/HOME HEALTH ADMINISTRATOR",
"AuthorizedOfficialNamePrefix": "MR.",
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "LMSW",
"AuthorizedOfficialTelephoneNumber": "803-576-2916",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "251E00000X",
"TaxonomyName": "Home Health Agency",
"LicenseNumber": "HHA-011",
"LicenseNumberStateCode": "SC",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}