{
"Npi": {
"NPI": "1821359506",
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"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "MASSOUD TALAIE, RPT INC",
"LastName": null,
"FirstName": null,
"MiddleName": null,
"NamePrefix": null,
"NameSuffix": null,
"Credential": null,
"OtherOrgName": null,
"OtherOrgNameTypeCode": null,
"OtherLastName": null,
"OtherFirstName": null,
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"OtherCredential": null,
"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "6410 ROCKLEDGE DR",
"SecondLineMailingAddress": "SUITE 309",
"MailingAddressCityName": "BETHESDA",
"MailingAddressStateName": "MD",
"MailingAddressPostalCode": "20817-1809",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "301-897-9187",
"MailingAddressFaxNumber": "301-530-4120",
"FirstLinePracticeLocationAddress": "6410 ROCKLEDGE DR",
"SecondLinePracticeLocationAddress": "SUITE 309",
"PracticeLocationAddressCityName": "BETHESDA",
"PracticeLocationAddressStateName": "MD",
"PracticeLocationAddressPostalCode": "20817-1809",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "301-897-9187",
"PracticeLocationAddressFaxNumber": "301-530-4120",
"EnumerationDate": "05/30/2012",
"LastUpdateDate": "05/30/2012",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "TALAIE",
"AuthorizedOfficialFirstName": "MASSOUD",
"AuthorizedOfficialMiddleName": null,
"AuthorizedOfficialTitle": "OWNER",
"AuthorizedOfficialNamePrefix": "MR.",
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "RPT",
"AuthorizedOfficialTelephoneNumber": "301-897-9187",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "225100000X",
"TaxonomyName": "Physical Therapist",
"LicenseNumber": "15789",
"LicenseNumberStateCode": "MD",
"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."
}
}
}
}