{
"Npi": {
"NPI": "1629229612",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "Y",
"ParentOrgLBN": "CAROLINA PROSTHETICS & ORTHOTICS INC.",
"ParentOrgTIN": null,
"OrgName": "CAROLINA PROSTHETICS & ORTHOTICS INC.",
"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": "110 LINER DR",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "GREENWOOD",
"MailingAddressStateName": "SC",
"MailingAddressPostalCode": "29646-2310",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "864-653-4300",
"MailingAddressFaxNumber": "864-653-4600",
"FirstLinePracticeLocationAddress": "1011 TIGER BLVD",
"SecondLinePracticeLocationAddress": "SUITE 500",
"PracticeLocationAddressCityName": "CLEMSON",
"PracticeLocationAddressStateName": "SC",
"PracticeLocationAddressPostalCode": "29631-2915",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "864-653-4300",
"PracticeLocationAddressFaxNumber": "864-653-4600",
"EnumerationDate": "10/08/2008",
"LastUpdateDate": "11/03/2009",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "MCCREA",
"AuthorizedOfficialFirstName": "WILLIAM",
"AuthorizedOfficialMiddleName": "T",
"AuthorizedOfficialTitle": "PROSTHETIST/ORTHOTIST/OWNER",
"AuthorizedOfficialNamePrefix": null,
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "CPO",
"AuthorizedOfficialTelephoneNumber": "864-653-4600",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "335E00000X",
"TaxonomyName": "Prosthetic/Orthotic Supplier",
"LicenseNumber": null,
"LicenseNumberStateCode": null,
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}