{
"Npi": {
"NPI": "1710388665",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "Y",
"ParentOrgLBN": "GENERATION COVENANT",
"ParentOrgTIN": null,
"OrgName": "GENERATION COVENANT HEALTHCARE",
"LastName": null,
"FirstName": null,
"MiddleName": null,
"NamePrefix": null,
"NameSuffix": null,
"Credential": null,
"OtherOrgName": null,
"OtherOrgNameTypeCode": "6",
"OtherLastName": null,
"OtherFirstName": null,
"OtherMiddleName": null,
"OtherNamePrefix": null,
"OtherNameSuffix": null,
"OtherCredential": null,
"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "PO BOX 2507",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "LUBBOCK",
"MailingAddressStateName": "TX",
"MailingAddressPostalCode": "79408-2507",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "806-741-0268",
"MailingAddressFaxNumber": "806-741-0142",
"FirstLinePracticeLocationAddress": "14 BRIERCROFT OFFICE PARK",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "LUBBOCK",
"PracticeLocationAddressStateName": "TX",
"PracticeLocationAddressPostalCode": "79412-3035",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "806-795-7123",
"PracticeLocationAddressFaxNumber": "806-795-7172",
"EnumerationDate": "09/10/2014",
"LastUpdateDate": "09/10/2014",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "CONDRA",
"AuthorizedOfficialFirstName": "MERINDA",
"AuthorizedOfficialMiddleName": "KATHRYN",
"AuthorizedOfficialTitle": "CHIEF EXECUTIVE OFFICER",
"AuthorizedOfficialNamePrefix": null,
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": null,
"AuthorizedOfficialTelephoneNumber": "806-741-0268",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "261QF0050X",
"TaxonomyName": "Non-Surgical Family Planning Clinic/Center",
"LicenseNumber": null,
"LicenseNumberStateCode": null,
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}