{
"Npi": {
"NPI": "1740466986",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "K4E-SC CHIROPRACTIC, PC",
"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": "310 BROAD ST",
"SecondLineMailingAddress": "SUITE 2E",
"MailingAddressCityName": "CHARLESTON",
"MailingAddressStateName": "SC",
"MailingAddressPostalCode": "29401-1200",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "843-723-1001",
"MailingAddressFaxNumber": "843-723-8009",
"FirstLinePracticeLocationAddress": "310 BROAD ST",
"SecondLinePracticeLocationAddress": "SUITE 2E",
"PracticeLocationAddressCityName": "CHARLESTON",
"PracticeLocationAddressStateName": "SC",
"PracticeLocationAddressPostalCode": "29401-1200",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "843-723-1001",
"PracticeLocationAddressFaxNumber": "843-723-8009",
"EnumerationDate": "01/17/2008",
"LastUpdateDate": "02/26/2008",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "KFOURY",
"AuthorizedOfficialFirstName": "PETER",
"AuthorizedOfficialMiddleName": "WILLIAM",
"AuthorizedOfficialTitle": "CHIROPRACTOR / OWNER",
"AuthorizedOfficialNamePrefix": "DR.",
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "D.C.",
"AuthorizedOfficialTelephoneNumber": "843-723-1001",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "261Q00000X",
"TaxonomyName": "Clinic/Center",
"LicenseNumber": "779",
"LicenseNumberStateCode": "SC",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}