{
"Npi": {
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"ReplacementNPI": null,
"EIN": null,
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"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "FREEMAN PHYSICAL THERAPY",
"LastName": null,
"FirstName": null,
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"NamePrefix": null,
"NameSuffix": null,
"Credential": null,
"OtherOrgName": null,
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"OtherCredential": null,
"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "1990 S FRONTAGE RD",
"SecondLineMailingAddress": "SUITE J",
"MailingAddressCityName": "VICKSBURG",
"MailingAddressStateName": "MS",
"MailingAddressPostalCode": "39180-5232",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "601-738-5714",
"MailingAddressFaxNumber": "855-753-9454",
"FirstLinePracticeLocationAddress": "1990 S FRONTAGE RD",
"SecondLinePracticeLocationAddress": "SUITE J",
"PracticeLocationAddressCityName": "VICKSBURG",
"PracticeLocationAddressStateName": "MS",
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"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "601-738-5714",
"PracticeLocationAddressFaxNumber": "855-753-9454",
"EnumerationDate": "07/10/2015",
"LastUpdateDate": "07/10/2015",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "FREEMAN",
"AuthorizedOfficialFirstName": "DAVID",
"AuthorizedOfficialMiddleName": "RON",
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"AuthorizedOfficialNamePrefix": null,
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "PT",
"AuthorizedOfficialTelephoneNumber": "601-529-9193",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "261QP2000X",
"TaxonomyName": "Physical Therapy Clinic/Center",
"LicenseNumber": "PT0703",
"LicenseNumberStateCode": "MS",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}