{
"Npi": {
"NPI": "1740311216",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "NEPTUNE",
"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": "525 FELLOWSHIP RD",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "MOUNT LAUREL",
"MailingAddressStateName": "NJ",
"MailingAddressPostalCode": "08054-3415",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "856-813-2000",
"MailingAddressFaxNumber": "856-813-2020",
"FirstLinePracticeLocationAddress": "101 WALNUT ST",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "NEPTUNE",
"PracticeLocationAddressStateName": "NJ",
"PracticeLocationAddressPostalCode": "07753-4301",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "732-774-3550",
"PracticeLocationAddressFaxNumber": "732-775-7534",
"EnumerationDate": "03/08/2007",
"LastUpdateDate": "08/14/2007",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "CLARK",
"AuthorizedOfficialFirstName": "TRAMELL",
"AuthorizedOfficialMiddleName": "C",
"AuthorizedOfficialTitle": "REGIONAL RESIDENT ACCOUNTING MGR",
"AuthorizedOfficialNamePrefix": "MRS.",
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": null,
"AuthorizedOfficialTelephoneNumber": "856-813-2000",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "314000000X",
"TaxonomyName": "Skilled Nursing Facility",
"LicenseNumber": "061304",
"LicenseNumberStateCode": "NJ",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}