{
"Npi": {
"NPI": "1770880031",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "A. CLAY ROBY DC 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": "4460 N ILLINOIS ST",
"SecondLineMailingAddress": "SUITE 5",
"MailingAddressCityName": "SWANSEA",
"MailingAddressStateName": "IL",
"MailingAddressPostalCode": "62226-1899",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "618-234-2761",
"MailingAddressFaxNumber": "618-257-3291",
"FirstLinePracticeLocationAddress": "4460 N ILLINOIS ST",
"SecondLinePracticeLocationAddress": "SUITE 5",
"PracticeLocationAddressCityName": "SWANSEA",
"PracticeLocationAddressStateName": "IL",
"PracticeLocationAddressPostalCode": "62226-1899",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "618-234-2761",
"PracticeLocationAddressFaxNumber": "618-257-3291",
"EnumerationDate": "02/23/2011",
"LastUpdateDate": "02/23/2011",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "ROBY",
"AuthorizedOfficialFirstName": "AARON",
"AuthorizedOfficialMiddleName": "CLAY",
"AuthorizedOfficialTitle": "CHIROPRACTOR",
"AuthorizedOfficialNamePrefix": "DR.",
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "D.C.",
"AuthorizedOfficialTelephoneNumber": "618-234-2761",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "261QR0400X",
"TaxonomyName": "Rehabilitation Clinic/Center",
"LicenseNumber": "038.011690",
"LicenseNumberStateCode": "IL",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}