{
"Npi": {
"NPI": "1700140795",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "GULF COAST PATIENT CARE NETWORK, 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": "3280 DAUPHIN ST",
"SecondLineMailingAddress": "BUILDING C, SUITE 115",
"MailingAddressCityName": "MOBILE",
"MailingAddressStateName": "AL",
"MailingAddressPostalCode": "36606-4060",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "251-709-8998",
"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "3280 DAUPHIN ST",
"SecondLinePracticeLocationAddress": "BUILDING C, SUITE 115",
"PracticeLocationAddressCityName": "MOBILE",
"PracticeLocationAddressStateName": "AL",
"PracticeLocationAddressPostalCode": "36606-4060",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "251-709-8998",
"PracticeLocationAddressFaxNumber": null,
"EnumerationDate": "06/25/2012",
"LastUpdateDate": "06/25/2012",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "O'CONNOR",
"AuthorizedOfficialFirstName": "LAURA",
"AuthorizedOfficialMiddleName": "M.",
"AuthorizedOfficialTitle": "EXECUTIVE DIRECTOR",
"AuthorizedOfficialNamePrefix": "MRS.",
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "MHHA",
"AuthorizedOfficialTelephoneNumber": "251-709-8998",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "251B00000X",
"TaxonomyName": "Case Management Agency",
"LicenseNumber": null,
"LicenseNumberStateCode": null,
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}