{
"Npi": {
"NPI": "1730164674",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "MS STATE DEPARTMENT OF HEALTH",
"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 1700",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "JACKSON",
"MailingAddressStateName": "MS",
"MailingAddressPostalCode": "39215-1700",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "601-987-4995",
"MailingAddressFaxNumber": "601-987-8633",
"FirstLinePracticeLocationAddress": "350 WEST WOODROW WILSON AVENUE",
"SecondLinePracticeLocationAddress": "HINDS COUNTY HEALTH DEPARTMENT SUITE 411-A",
"PracticeLocationAddressCityName": "JACKSON",
"PracticeLocationAddressStateName": "MS",
"PracticeLocationAddressPostalCode": "39213",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "601-987-4995",
"PracticeLocationAddressFaxNumber": "601-987-8633",
"EnumerationDate": "12/14/2005",
"LastUpdateDate": "07/14/2008",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "BOWMAN",
"AuthorizedOfficialFirstName": "MELANIE",
"AuthorizedOfficialMiddleName": null,
"AuthorizedOfficialTitle": "DIRECTOR OF HOME HEALTH",
"AuthorizedOfficialNamePrefix": "MRS.",
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "RN",
"AuthorizedOfficialTelephoneNumber": "601-576-7853",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "251E00000X",
"TaxonomyName": "Home Health Agency",
"LicenseNumber": "7881",
"LicenseNumberStateCode": "MS",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}