{
"Npi": {
"NPI": "1699014993",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "MEDX HEARING CENTER",
"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": "4665 W ATLANTIC AVE",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "DELRAY BEACH",
"MailingAddressStateName": "FL",
"MailingAddressPostalCode": "33445-3800",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "561-638-4733",
"MailingAddressFaxNumber": "561-638-4734",
"FirstLinePracticeLocationAddress": "4665 W ATLANTIC AVE",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "DELRAY BEACH",
"PracticeLocationAddressStateName": "FL",
"PracticeLocationAddressPostalCode": "33445-3800",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "561-638-4733",
"PracticeLocationAddressFaxNumber": "561-638-4734",
"EnumerationDate": "02/06/2013",
"LastUpdateDate": "02/06/2013",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "FORSYTH",
"AuthorizedOfficialFirstName": "MARK",
"AuthorizedOfficialMiddleName": "A",
"AuthorizedOfficialTitle": "OWNER PRESIDENT",
"AuthorizedOfficialNamePrefix": "MR.",
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "BCHIS",
"AuthorizedOfficialTelephoneNumber": "561-638-4733",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "332S00000X",
"TaxonomyName": "Hearing Aid Equipment",
"LicenseNumber": null,
"LicenseNumberStateCode": null,
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}