{
"Npi": {
"NPI": "1821392325",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "Y",
"ParentOrgLBN": "LESTER E. COX MEDICAL CENTERS",
"ParentOrgTIN": null,
"OrgName": "SPRINGFIELD NEUROLOGICAL AND SPINE INSTITUTE",
"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": "PO BOX 9434",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "SPRINGFIELD",
"MailingAddressStateName": "MO",
"MailingAddressPostalCode": "65801-9434",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "417-885-3888",
"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "1401 HIGHWAY 62 65 N",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "HARRISON",
"PracticeLocationAddressStateName": "AR",
"PracticeLocationAddressPostalCode": "72601-1701",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "417-885-3888",
"PracticeLocationAddressFaxNumber": null,
"EnumerationDate": "12/27/2010",
"LastUpdateDate": "10/31/2025",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "WILLIAMS",
"AuthorizedOfficialFirstName": "BRYAN",
"AuthorizedOfficialMiddleName": null,
"AuthorizedOfficialTitle": "VP OF OPERATIONS",
"AuthorizedOfficialNamePrefix": null,
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": null,
"AuthorizedOfficialTelephoneNumber": "417-379-3312",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "207T00000X",
"TaxonomyName": "Neurological Surgery Physician",
"LicenseNumber": null,
"LicenseNumberStateCode": null,
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": {
"HealthcareProviderTaxonomyGroup": {
"HealthcareProviderTaxonomyGroupName": "193200000X MULTI-SPECIALTY GROUP",
"HealthcareProviderTaxonomyGroupDescription": "Multi-Specialty Group - A business group of one or more individual practitioners, who practice with different areas of specialization."
}
}
}
}