{
"Npi": {
"NPI": "1710200928",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "KAREN E. AGERSBOG, D.O. ASSOCIATES, P.C.",
"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": "8815 GERMANTOWN AVE",
"SecondLineMailingAddress": "SUITE 14",
"MailingAddressCityName": "PHILADELPHIA",
"MailingAddressStateName": "PA",
"MailingAddressPostalCode": "19118-2722",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "215-248-2600",
"MailingAddressFaxNumber": "215-248-2606",
"FirstLinePracticeLocationAddress": "8815 GERMANTOWN AVE",
"SecondLinePracticeLocationAddress": "SUITE 14",
"PracticeLocationAddressCityName": "PHILADELPHIA",
"PracticeLocationAddressStateName": "PA",
"PracticeLocationAddressPostalCode": "19118-2722",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "215-248-2600",
"PracticeLocationAddressFaxNumber": "215-248-2606",
"EnumerationDate": "03/03/2010",
"LastUpdateDate": "03/03/2010",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "AGERSBORG",
"AuthorizedOfficialFirstName": "KAREN",
"AuthorizedOfficialMiddleName": "ELIZABETH",
"AuthorizedOfficialTitle": "PRESIDENT/OWNER",
"AuthorizedOfficialNamePrefix": "DR.",
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "DO, FACOI, FACE",
"AuthorizedOfficialTelephoneNumber": "215-248-2600",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "261QM2500X",
"TaxonomyName": "Medical Specialty Clinic/Center",
"LicenseNumber": "OS010570L",
"LicenseNumberStateCode": "PA",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}