{
"Npi": {
"NPI": "1720290794",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "Y",
"ParentOrgLBN": "CAH ACQUISITION COMPANY #1 LLC",
"ParentOrgTIN": null,
"OrgName": "CAH ACQUISITION COMPANY # 1",
"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": "7920 BELT LINE RD STE 215",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "DALLAS",
"MailingAddressStateName": "TX",
"MailingAddressPostalCode": "75254-8155",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "214-502-9624",
"MailingAddressFaxNumber": "252-793-1530",
"FirstLinePracticeLocationAddress": "1006 US HWY 64 EAST",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "PLYMOUTH",
"PracticeLocationAddressStateName": "NC",
"PracticeLocationAddressPostalCode": "27962-9215",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "252-793-7701",
"PracticeLocationAddressFaxNumber": "252-793-1530",
"EnumerationDate": "05/04/2007",
"LastUpdateDate": "05/11/2020",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "AVIGNONE",
"AuthorizedOfficialFirstName": "FRANK",
"AuthorizedOfficialMiddleName": "TITUS",
"AuthorizedOfficialTitle": "CEO",
"AuthorizedOfficialNamePrefix": null,
"AuthorizedOfficialNameSuffix": "IV",
"AuthorizedOfficialCredential": null,
"AuthorizedOfficialTelephoneNumber": "214-502-9624",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "261QR1300X",
"TaxonomyName": "Rural Health Clinic/Center",
"LicenseNumber": "H0006",
"LicenseNumberStateCode": "NC",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}