{
"Npi": {
"NPI": "1801849427",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "MAIN STREET ASC LLC",
"LastName": null,
"FirstName": null,
"MiddleName": null,
"NamePrefix": null,
"NameSuffix": null,
"Credential": null,
"OtherOrgName": null,
"OtherOrgNameTypeCode": "6",
"OtherLastName": null,
"OtherFirstName": null,
"OtherMiddleName": null,
"OtherNamePrefix": null,
"OtherNameSuffix": null,
"OtherCredential": null,
"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "1318 EISENHOWER BOULEVARD",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "JOHNSTOWN",
"MailingAddressStateName": "PA",
"MailingAddressPostalCode": "15904-3307",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "814-266-5795",
"MailingAddressFaxNumber": "814-266-5793",
"FirstLinePracticeLocationAddress": "1318 EISENHOWER BLVD",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "JOHNSTOWN",
"PracticeLocationAddressStateName": "PA",
"PracticeLocationAddressPostalCode": "15904-3307",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "814-536-5343",
"PracticeLocationAddressFaxNumber": "814-536-1525",
"EnumerationDate": "05/17/2006",
"LastUpdateDate": "04/15/2011",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "POLITO",
"AuthorizedOfficialFirstName": "JOSEPH",
"AuthorizedOfficialMiddleName": "R",
"AuthorizedOfficialTitle": "PRESIDENT GOVERNING BODY",
"AuthorizedOfficialNamePrefix": "DR.",
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "MD",
"AuthorizedOfficialTelephoneNumber": "814-266-5795",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "261QA1903X",
"TaxonomyName": "Ambulatory Surgical Clinic/Center",
"LicenseNumber": "APPLIED",
"LicenseNumberStateCode": "PA",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}