{
"Npi": {
"NPI": "1831376508",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "COHEN PODIATRY CLINICS",
"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": "12056 MOBILE AVE",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "GULFPORT",
"MailingAddressStateName": "MS",
"MailingAddressPostalCode": "39503-3004",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "228-832-4475",
"MailingAddressFaxNumber": "228-832-1512",
"FirstLinePracticeLocationAddress": "12056 MOBILE AVE",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "GULFPORT",
"PracticeLocationAddressStateName": "MS",
"PracticeLocationAddressPostalCode": "39503-3004",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "228-832-4475",
"PracticeLocationAddressFaxNumber": "228-832-1512",
"EnumerationDate": "01/24/2008",
"LastUpdateDate": "01/29/2008",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "COHEN",
"AuthorizedOfficialFirstName": "EDWARD",
"AuthorizedOfficialMiddleName": "ROBERT",
"AuthorizedOfficialTitle": "PODIATRIST",
"AuthorizedOfficialNamePrefix": "DR.",
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "D.P.M.",
"AuthorizedOfficialTelephoneNumber": "228-832-4475",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "261QP1100X",
"TaxonomyName": "Podiatric Clinic/Center",
"LicenseNumber": "80055",
"LicenseNumberStateCode": "MS",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}