{
"Npi": {
"NPI": "1780941484",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "CHARLES E. GARRETT JR",
"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": "2351 WIENBURG DR",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "DAYTON",
"MailingAddressStateName": "OH",
"MailingAddressPostalCode": "45439-7944",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "937-520-0395",
"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "2351 WIENBURG DR",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "DAYTON",
"PracticeLocationAddressStateName": "OH",
"PracticeLocationAddressPostalCode": "45439-7944",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "937-520-0395",
"PracticeLocationAddressFaxNumber": null,
"EnumerationDate": "04/18/2012",
"LastUpdateDate": "04/18/2012",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "GARRETT",
"AuthorizedOfficialFirstName": "CHARLES",
"AuthorizedOfficialMiddleName": "EDWARD",
"AuthorizedOfficialTitle": "STNA",
"AuthorizedOfficialNamePrefix": "MR.",
"AuthorizedOfficialNameSuffix": "JR.",
"AuthorizedOfficialCredential": null,
"AuthorizedOfficialTelephoneNumber": "937-520-0395",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "314000000X",
"TaxonomyName": "Skilled Nursing Facility",
"LicenseNumber": "400598840307",
"LicenseNumberStateCode": "OH",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}