{
"Npi": {
"NPI": "1790043537",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "Y",
"ParentOrgLBN": "SOUTHERN ORTHOCARE",
"ParentOrgTIN": null,
"OrgName": "SOUTHERN ORTHOCARE INC",
"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": "622 W 1ST NORTH ST",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "MORRISTOWN",
"MailingAddressStateName": "TN",
"MailingAddressPostalCode": "37814-4544",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "423-307-1890",
"MailingAddressFaxNumber": "423-307-1891",
"FirstLinePracticeLocationAddress": "705 N 12TH ST",
"SecondLinePracticeLocationAddress": "SUITE 250",
"PracticeLocationAddressCityName": "MIDDLESBORO",
"PracticeLocationAddressStateName": "KY",
"PracticeLocationAddressPostalCode": "40965-1835",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "606-302-4002",
"PracticeLocationAddressFaxNumber": "606-302-4005",
"EnumerationDate": "04/30/2012",
"LastUpdateDate": "04/28/2025",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "HUNTSMAN",
"AuthorizedOfficialFirstName": "JOSEPH",
"AuthorizedOfficialMiddleName": null,
"AuthorizedOfficialTitle": "CEO/OWNER",
"AuthorizedOfficialNamePrefix": null,
"AuthorizedOfficialNameSuffix": "JR.",
"AuthorizedOfficialCredential": null,
"AuthorizedOfficialTelephoneNumber": "423-307-1890",
"Taxonomies": {
"Taxonomy": [
{
"TaxonomyCode": "332B00000X",
"TaxonomyName": "Durable Medical Equipment & Medical Supplies",
"LicenseNumber": null,
"LicenseNumberStateCode": null,
"PrimaryTaxonomySwitch": "N"
},
{
"TaxonomyCode": "335E00000X",
"TaxonomyName": "Prosthetic/Orthotic Supplier",
"LicenseNumber": null,
"LicenseNumberStateCode": null,
"PrimaryTaxonomySwitch": "Y"
}
]
},
"HealthcareProviderTaxonomyGroups": null
}
}