{
"Npi": {
"NPI": "1588892293",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "COVINGTON CLINIC PC",
"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": "4480 COVINGTON HWY",
"SecondLineMailingAddress": "SUITE B",
"MailingAddressCityName": "DECATUR",
"MailingAddressStateName": "GA",
"MailingAddressPostalCode": "30035-1218",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "404-775-1973",
"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "4480 COVINGTON HWY",
"SecondLinePracticeLocationAddress": "SUITE B",
"PracticeLocationAddressCityName": "DECATUR",
"PracticeLocationAddressStateName": "GA",
"PracticeLocationAddressPostalCode": "30035-1218",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "404-775-1973",
"PracticeLocationAddressFaxNumber": null,
"EnumerationDate": "07/01/2009",
"LastUpdateDate": "07/04/2009",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "DANIA",
"AuthorizedOfficialFirstName": "FRANK",
"AuthorizedOfficialMiddleName": "OJO",
"AuthorizedOfficialTitle": "PRESIDENT/CEO",
"AuthorizedOfficialNamePrefix": "DR.",
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "M.D., M.S.",
"AuthorizedOfficialTelephoneNumber": "770-688-5558",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "261QP2300X",
"TaxonomyName": "Primary Care Clinic/Center",
"LicenseNumber": "061956",
"LicenseNumberStateCode": "GA",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}