{
"Npi": {
"NPI": "1760635809",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "ENVOY OF WINCHESTER, LLC",
"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": "110 LAUCK DR",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "WINCHESTER",
"MailingAddressStateName": "VA",
"MailingAddressPostalCode": "22603-4282",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "540-667-7830",
"MailingAddressFaxNumber": "540-667-2941",
"FirstLinePracticeLocationAddress": "110 LAUCK DR",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "WINCHESTER",
"PracticeLocationAddressStateName": "VA",
"PracticeLocationAddressPostalCode": "22603-4282",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "540-667-8830",
"PracticeLocationAddressFaxNumber": null,
"EnumerationDate": "11/03/2008",
"LastUpdateDate": "11/27/2023",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "USSERY",
"AuthorizedOfficialFirstName": "KENNETH",
"AuthorizedOfficialMiddleName": null,
"AuthorizedOfficialTitle": "VP",
"AuthorizedOfficialNamePrefix": null,
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": null,
"AuthorizedOfficialTelephoneNumber": "407-571-1550",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "314000000X",
"TaxonomyName": "Skilled Nursing Facility",
"LicenseNumber": null,
"LicenseNumberStateCode": null,
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}