{
"Npi": {
"NPI": "1720163090",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "FAYETTE MEDICAL CENTER AMBULANCE",
"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": "809 UNIVERSITY BLVD E",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "TUSCALOOSA",
"MailingAddressStateName": "AL",
"MailingAddressPostalCode": "35401-2029",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "205-343-8500",
"MailingAddressFaxNumber": "205-759-6397",
"FirstLinePracticeLocationAddress": "1653 TEMPLE AVE N",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "FAYETTE",
"PracticeLocationAddressStateName": "AL",
"PracticeLocationAddressPostalCode": "35555-1314",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "205-343-8500",
"PracticeLocationAddressFaxNumber": "205-759-6397",
"EnumerationDate": "10/26/2006",
"LastUpdateDate": "04/22/2022",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "HINDMAN",
"AuthorizedOfficialFirstName": "KERI",
"AuthorizedOfficialMiddleName": "H",
"AuthorizedOfficialTitle": "PAITENT ACCOUNTS DIRECTOR",
"AuthorizedOfficialNamePrefix": null,
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": null,
"AuthorizedOfficialTelephoneNumber": "205-759-7379",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "3416L0300X",
"TaxonomyName": "Land Ambulance",
"LicenseNumber": "226",
"LicenseNumberStateCode": "AL",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}