{
"Npi": {
"NPI": "1831465426",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "AA-PAIN MANAGEMENT P.C.",
"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": "3840 PEACHTREE INDUSTRIAL BLVD",
"SecondLineMailingAddress": "SUITE 220",
"MailingAddressCityName": "DULUTH",
"MailingAddressStateName": "GA",
"MailingAddressPostalCode": "30096-5031",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "770-331-3171",
"MailingAddressFaxNumber": "706-335-2257",
"FirstLinePracticeLocationAddress": "3840 PEACHTREE INDUSTRIAL BLVD",
"SecondLinePracticeLocationAddress": "SUITE 220",
"PracticeLocationAddressCityName": "DULUTH",
"PracticeLocationAddressStateName": "GA",
"PracticeLocationAddressPostalCode": "30096-5031",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "770-331-3171",
"PracticeLocationAddressFaxNumber": "706-335-2257",
"EnumerationDate": "03/28/2012",
"LastUpdateDate": "03/26/2014",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "PERRY",
"AuthorizedOfficialFirstName": "ALVIS",
"AuthorizedOfficialMiddleName": "T",
"AuthorizedOfficialTitle": "PRESIDENT",
"AuthorizedOfficialNamePrefix": "DR.",
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "M.D.",
"AuthorizedOfficialTelephoneNumber": "770-331-3171",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "261QP3300X",
"TaxonomyName": "Pain Clinic/Center",
"LicenseNumber": "034921",
"LicenseNumberStateCode": "GA",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}