{
"Npi": {
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"EIN": null,
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"IsOrgSubpart": "N",
"ParentOrgLBN": null,
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"OrgName": "ONE SOURCE DIAGNOSTICS, INC.",
"LastName": null,
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"NamePrefix": null,
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"FirstLineMailingAddress": "3314 16TH AVE SE",
"SecondLineMailingAddress": "SUITE 201",
"MailingAddressCityName": "CONOVER",
"MailingAddressStateName": "NC",
"MailingAddressPostalCode": "28613-9694",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "704-325-0810",
"MailingAddressFaxNumber": "704-325-0812",
"FirstLinePracticeLocationAddress": "3314 16TH AVE SE",
"SecondLinePracticeLocationAddress": "SUITE 201",
"PracticeLocationAddressCityName": "CONOVER",
"PracticeLocationAddressStateName": "NC",
"PracticeLocationAddressPostalCode": "28613-9694",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "704-325-0810",
"PracticeLocationAddressFaxNumber": "704-325-0812",
"EnumerationDate": "11/29/2007",
"LastUpdateDate": "11/29/2007",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "WHITE",
"AuthorizedOfficialFirstName": "BRADY",
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"AuthorizedOfficialTitle": "PRESIDENT",
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"AuthorizedOfficialCredential": "RRT-RCP",
"AuthorizedOfficialTelephoneNumber": "828-781-7413",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "261QS1200X",
"TaxonomyName": "Sleep Disorder Diagnostic Clinic/Center",
"LicenseNumber": "A-559",
"LicenseNumberStateCode": "NC",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}