{
"Npi": {
"NPI": "1831500883",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "NOBLE HEALTHCARE",
"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": "2389 RENAISSANCE DR",
"SecondLineMailingAddress": "SUITE A",
"MailingAddressCityName": "LAS VEGAS",
"MailingAddressStateName": "NV",
"MailingAddressPostalCode": "89119-6106",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "170-245-8149",
"MailingAddressFaxNumber": "170-245-8786",
"FirstLinePracticeLocationAddress": "2389 RENAISSANCE DR",
"SecondLinePracticeLocationAddress": "SUITE A",
"PracticeLocationAddressCityName": "LAS VEGAS",
"PracticeLocationAddressStateName": "NV",
"PracticeLocationAddressPostalCode": "89119-6106",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "170-245-8149",
"PracticeLocationAddressFaxNumber": "170-245-8786",
"EnumerationDate": "05/13/2014",
"LastUpdateDate": "05/13/2014",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "MOODY",
"AuthorizedOfficialFirstName": "JOHN",
"AuthorizedOfficialMiddleName": "PAUL",
"AuthorizedOfficialTitle": "PRESIDENT",
"AuthorizedOfficialNamePrefix": "DR.",
"AuthorizedOfficialNameSuffix": "III",
"AuthorizedOfficialCredential": "D.C.",
"AuthorizedOfficialTelephoneNumber": "17024581495",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "261QH0100X",
"TaxonomyName": "Health Service Clinic/Center",
"LicenseNumber": "B00793",
"LicenseNumberStateCode": "NV",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}