{
"Npi": {
"NPI": "1821151911",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "TI - KERRVILLE, L.L.C.",
"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": "808 GUADALUPE ST",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "KERRVILLE",
"MailingAddressStateName": "TX",
"MailingAddressPostalCode": "78028-5099",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "830-895-2636",
"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "808 GUADALUPE ST",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "KERRVILLE",
"PracticeLocationAddressStateName": "TX",
"PracticeLocationAddressPostalCode": "78028-5099",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "830-895-2636",
"PracticeLocationAddressFaxNumber": null,
"EnumerationDate": "12/19/2006",
"LastUpdateDate": "10/15/2010",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "TUTERA",
"AuthorizedOfficialFirstName": "JOSEPH",
"AuthorizedOfficialMiddleName": "C",
"AuthorizedOfficialTitle": "PRESIDENT, CEO",
"AuthorizedOfficialNamePrefix": "MR.",
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": null,
"AuthorizedOfficialTelephoneNumber": "816-444-0900",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "314000000X",
"TaxonomyName": "Skilled Nursing Facility",
"LicenseNumber": "15575",
"LicenseNumberStateCode": "TX",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}