{
"Npi": {
"NPI": "1710363486",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "MOTILITY MLK, LLC",
"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": "PO BOX 1966",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "HOT SPRINGS",
"MailingAddressStateName": "AR",
"MailingAddressPostalCode": "71902-1966",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "501-620-4800",
"MailingAddressFaxNumber": "848-272-8975",
"FirstLinePracticeLocationAddress": "120 HILL ST",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "HOT SPRINGS",
"PracticeLocationAddressStateName": "AR",
"PracticeLocationAddressPostalCode": "71901-6238",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "501-620-4800",
"PracticeLocationAddressFaxNumber": "848-272-8975",
"EnumerationDate": "08/05/2015",
"LastUpdateDate": "04/02/2025",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "KENNEY",
"AuthorizedOfficialFirstName": "RITA",
"AuthorizedOfficialMiddleName": "MARIE",
"AuthorizedOfficialTitle": "OWNER AND MANAGER",
"AuthorizedOfficialNamePrefix": null,
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": null,
"AuthorizedOfficialTelephoneNumber": "501-620-4800",
"Taxonomies": {
"Taxonomy": [
{
"TaxonomyCode": "335E00000X",
"TaxonomyName": "Prosthetic/Orthotic Supplier",
"LicenseNumber": "CP2198",
"LicenseNumberStateCode": "AR",
"PrimaryTaxonomySwitch": "N"
},
{
"TaxonomyCode": "332B00000X",
"TaxonomyName": "Durable Medical Equipment & Medical Supplies",
"LicenseNumber": null,
"LicenseNumberStateCode": null,
"PrimaryTaxonomySwitch": "Y"
}
]
},
"HealthcareProviderTaxonomyGroups": null
}
}