{
"Npi": {
"NPI": "1821261108",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "WRIGHT PAIN MANAGEMENT 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": "PO BOX 94568",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "PHOENIX",
"MailingAddressStateName": "AZ",
"MailingAddressPostalCode": "85070-4568",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "480-361-7680",
"MailingAddressFaxNumber": "480-361-7683",
"FirstLinePracticeLocationAddress": "13065 W MCDOWELL RAOD",
"SecondLinePracticeLocationAddress": "SUITE C-101",
"PracticeLocationAddressCityName": "AVONDALE",
"PracticeLocationAddressStateName": "AZ",
"PracticeLocationAddressPostalCode": "85392-4568",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "623-535-5629",
"PracticeLocationAddressFaxNumber": "623-535-5639",
"EnumerationDate": "04/08/2008",
"LastUpdateDate": "10/27/2009",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "WRIGHT",
"AuthorizedOfficialFirstName": "LEWIS",
"AuthorizedOfficialMiddleName": "EDWARD",
"AuthorizedOfficialTitle": "PRESIDENT OF COMPANY",
"AuthorizedOfficialNamePrefix": "DR.",
"AuthorizedOfficialNameSuffix": "JR.",
"AuthorizedOfficialCredential": "M.D.",
"AuthorizedOfficialTelephoneNumber": "623-433-0199",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "207LP2900X",
"TaxonomyName": "Pain Medicine (Anesthesiology) Physician",
"LicenseNumber": "34682",
"LicenseNumberStateCode": "AZ",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": {
"HealthcareProviderTaxonomyGroup": {
"HealthcareProviderTaxonomyGroupName": "193400000X SINGLE SPECIALTY GROUP",
"HealthcareProviderTaxonomyGroupDescription": "Single Specialty Group - A business group of one or more individual practitioners, all of who practice with the same area of specialization."
}
}
}
}