{
"Npi": {
"NPI": "1780743906",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "NRA-PORT LAVACA, TEXAS, 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": "730 COOL SPRINGS BLVD",
"SecondLineMailingAddress": "SUITE 100",
"MailingAddressCityName": "FRANKLIN",
"MailingAddressStateName": "TN",
"MailingAddressPostalCode": "37067-7289",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "615-771-4400",
"MailingAddressFaxNumber": "615-771-4401",
"FirstLinePracticeLocationAddress": "1300 N VIRGINIA ST",
"SecondLinePracticeLocationAddress": "SUITE 102",
"PracticeLocationAddressCityName": "PORT LAVACA",
"PracticeLocationAddressStateName": "TX",
"PracticeLocationAddressPostalCode": "77979-2509",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "361-551-2566",
"PracticeLocationAddressFaxNumber": null,
"EnumerationDate": "12/06/2006",
"LastUpdateDate": "08/22/2020",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "CASHIA",
"AuthorizedOfficialFirstName": "JOSEPH",
"AuthorizedOfficialMiddleName": "A",
"AuthorizedOfficialTitle": "CHIEF MANAGER",
"AuthorizedOfficialNamePrefix": "MR.",
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": null,
"AuthorizedOfficialTelephoneNumber": "615-771-4400",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "261QE0700X",
"TaxonomyName": "End-Stage Renal Disease (ESRD) Treatment Clinic/Center",
"LicenseNumber": "PENDING",
"LicenseNumberStateCode": "TX",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}