{
"Npi": {
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"EIN": null,
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"IsOrgSubpart": "N",
"ParentOrgLBN": null,
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"OrgName": "RESTORATIVE PHYSICAL THERAPY & WELLNESS LLC",
"LastName": null,
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"NamePrefix": null,
"NameSuffix": null,
"Credential": null,
"OtherOrgName": null,
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"OtherCredential": null,
"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "900 STANHOPE GDNS STE 101",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "CHESAPEAKE",
"MailingAddressStateName": "VA",
"MailingAddressPostalCode": "23320-0755",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "757-842-6562",
"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "900 STANHOPE GDNS",
"SecondLinePracticeLocationAddress": "SUITE 101",
"PracticeLocationAddressCityName": "CHESAPEAKE",
"PracticeLocationAddressStateName": "VA",
"PracticeLocationAddressPostalCode": "23320",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "757-842-6562",
"PracticeLocationAddressFaxNumber": null,
"EnumerationDate": "10/22/2015",
"LastUpdateDate": "08/20/2018",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "BALDWIN",
"AuthorizedOfficialFirstName": "ASHLEY",
"AuthorizedOfficialMiddleName": "NICOLE",
"AuthorizedOfficialTitle": "PHYSICAL THERAPIST",
"AuthorizedOfficialNamePrefix": "MRS.",
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "DPT",
"AuthorizedOfficialTelephoneNumber": "757-842-6562",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "261QP2000X",
"TaxonomyName": "Physical Therapy Clinic/Center",
"LicenseNumber": "2305206158",
"LicenseNumberStateCode": "VA",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}