{
"Npi": {
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"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "JBCHIRO1 LLC",
"LastName": null,
"FirstName": null,
"MiddleName": null,
"NamePrefix": null,
"NameSuffix": null,
"Credential": null,
"OtherOrgName": null,
"OtherOrgNameTypeCode": "6",
"OtherLastName": null,
"OtherFirstName": null,
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"OtherNamePrefix": null,
"OtherNameSuffix": null,
"OtherCredential": null,
"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "11516 LAMEY BRIDGE RD",
"SecondLineMailingAddress": "SUITE E",
"MailingAddressCityName": "DIBERVILLE",
"MailingAddressStateName": "MS",
"MailingAddressPostalCode": "39540-2725",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "228-207-6427",
"MailingAddressFaxNumber": "228-207-6428",
"FirstLinePracticeLocationAddress": "11516 LAMEY BRIDGE RD",
"SecondLinePracticeLocationAddress": "SUITE E",
"PracticeLocationAddressCityName": "DIBERVILLE",
"PracticeLocationAddressStateName": "MS",
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"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "228-207-6427",
"PracticeLocationAddressFaxNumber": "228-207-6428",
"EnumerationDate": "11/05/2015",
"LastUpdateDate": "11/05/2015",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "BAMBAN",
"AuthorizedOfficialFirstName": "JOHN",
"AuthorizedOfficialMiddleName": null,
"AuthorizedOfficialTitle": "OWNER",
"AuthorizedOfficialNamePrefix": "DR.",
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "DC",
"AuthorizedOfficialTelephoneNumber": "228-207-6427",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "305R00000X",
"TaxonomyName": "Preferred Provider Organization",
"LicenseNumber": "1179",
"LicenseNumberStateCode": "MS",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}