{
"Npi": {
"NPI": "1801950894",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "MEDICAL COMPANY",
"LastName": null,
"FirstName": null,
"MiddleName": null,
"NamePrefix": null,
"NameSuffix": null,
"Credential": null,
"OtherOrgName": null,
"OtherOrgNameTypeCode": "6",
"OtherLastName": null,
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"OtherMiddleName": null,
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"OtherNameSuffix": null,
"OtherCredential": null,
"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "11690 CHANCEFORD DR",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "WOODBRIDGE",
"MailingAddressStateName": "VA",
"MailingAddressPostalCode": "22192-5567",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "703-490-8106",
"MailingAddressFaxNumber": "703-490-8107",
"FirstLinePracticeLocationAddress": "14555 POTOMAC MILLS ROAD",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "WOODBRIDGE",
"PracticeLocationAddressStateName": "VA",
"PracticeLocationAddressPostalCode": "22192-5567",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "703-490-8106",
"PracticeLocationAddressFaxNumber": "703-490-8107",
"EnumerationDate": "12/21/2006",
"LastUpdateDate": "08/22/2020",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "MCCLATCHEY",
"AuthorizedOfficialFirstName": "ANNETTE",
"AuthorizedOfficialMiddleName": "FLEMING",
"AuthorizedOfficialTitle": "ADMINISTRATOR",
"AuthorizedOfficialNamePrefix": null,
"AuthorizedOfficialNameSuffix": "IX",
"AuthorizedOfficialCredential": null,
"AuthorizedOfficialTelephoneNumber": "703-490-8106",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "332B00000X",
"TaxonomyName": "Durable Medical Equipment & Medical Supplies",
"LicenseNumber": "0206009192",
"LicenseNumberStateCode": "VA",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}