{
"Npi": {
"NPI": "1740305903",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "LUEBBE HEARING SERVICES",
"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": "210 SHARON RD",
"SecondLineMailingAddress": "SUITE 1",
"MailingAddressCityName": "CIRCLEVILLE",
"MailingAddressStateName": "OH",
"MailingAddressPostalCode": "43113-1498",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "740-474-8475",
"MailingAddressFaxNumber": "740-477-2430",
"FirstLinePracticeLocationAddress": "210 SHARON RD",
"SecondLinePracticeLocationAddress": "SUITE 1",
"PracticeLocationAddressCityName": "CIRCLEVILLE",
"PracticeLocationAddressStateName": "OH",
"PracticeLocationAddressPostalCode": "43113-1498",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "740-474-8475",
"PracticeLocationAddressFaxNumber": "740-477-2430",
"EnumerationDate": "03/20/2007",
"LastUpdateDate": "09/05/2008",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "GEARHART",
"AuthorizedOfficialFirstName": "MARY",
"AuthorizedOfficialMiddleName": "LOU",
"AuthorizedOfficialTitle": "ADMINISTRATOR",
"AuthorizedOfficialNamePrefix": null,
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "AUD",
"AuthorizedOfficialTelephoneNumber": "740-474-8475",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "231H00000X",
"TaxonomyName": "Audiologist",
"LicenseNumber": "A00304",
"LicenseNumberStateCode": "OH",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": {
"HealthcareProviderTaxonomyGroup": {
"HealthcareProviderTaxonomyGroupName": "193400000X SINGLE SPECIALTY GROUP",
"HealthcareProviderTaxonomyGroupDescription": "Single Specialty Group - A business group of one or more individual practitioners, all of who practice with the same area of specialization."
}
}
}
}