{
"Npi": {
"NPI": "1689822744",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "C. CORDELL ADAMS MD PA",
"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": "712 N WASHINGTON AVE STE 415",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "DALLAS",
"MailingAddressStateName": "TX",
"MailingAddressPostalCode": "75246-1634",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "214-826-7231",
"MailingAddressFaxNumber": "214-826-7984",
"FirstLinePracticeLocationAddress": "712 N WASHINGTON AVE STE 415",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "DALLAS",
"PracticeLocationAddressStateName": "TX",
"PracticeLocationAddressPostalCode": "75246-1634",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "214-826-7231",
"PracticeLocationAddressFaxNumber": "214-826-7984",
"EnumerationDate": "09/03/2008",
"LastUpdateDate": "09/25/2024",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "ADAMS",
"AuthorizedOfficialFirstName": "CEDRIC",
"AuthorizedOfficialMiddleName": "CORDELL",
"AuthorizedOfficialTitle": "OWNER/PHYSICIAN",
"AuthorizedOfficialNamePrefix": "DR.",
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "M.D.",
"AuthorizedOfficialTelephoneNumber": "214-826-7231",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "261QM2500X",
"TaxonomyName": "Medical Specialty Clinic/Center",
"LicenseNumber": "H2202",
"LicenseNumberStateCode": "TX",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}