{
"Npi": {
"NPI": "1730262668",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "SNOWSHOE MOUNTAIN INC.",
"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": "10 SNOWSHOE DR.",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "SNOWSHOE",
"MailingAddressStateName": "WV",
"MailingAddressPostalCode": "26209",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "304-572-5694",
"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "10 SNOWSHOE DR.",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "SNOWSHOE",
"PracticeLocationAddressStateName": "WV",
"PracticeLocationAddressPostalCode": "26209",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "304-572-5694",
"PracticeLocationAddressFaxNumber": null,
"EnumerationDate": "10/23/2006",
"LastUpdateDate": "08/22/2020",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "WHITE",
"AuthorizedOfficialFirstName": "HANS",
"AuthorizedOfficialMiddleName": "JURGEN",
"AuthorizedOfficialTitle": "ASSISTANT DIRECTOR",
"AuthorizedOfficialNamePrefix": "MR.",
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "PA",
"AuthorizedOfficialTelephoneNumber": "304-572-5694",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "261QU0200X",
"TaxonomyName": "Urgent Care Clinic/Center",
"LicenseNumber": "976331",
"LicenseNumberStateCode": "WV",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}