{
"Npi": {
"NPI": "1841233970",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "COOK MANAGEMENT SERVICES INC",
"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 1243",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "DUBLIN",
"MailingAddressStateName": "GA",
"MailingAddressPostalCode": "31040-1243",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "478-272-7437",
"MailingAddressFaxNumber": "478-272-2427",
"FirstLinePracticeLocationAddress": "300 INDUSTRIAL BLVD",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "DUBLIN",
"PracticeLocationAddressStateName": "GA",
"PracticeLocationAddressPostalCode": "31021-2800",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "478-272-7437",
"PracticeLocationAddressFaxNumber": "478-272-2427",
"EnumerationDate": "06/14/2006",
"LastUpdateDate": "07/02/2015",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "COOK",
"AuthorizedOfficialFirstName": "TERRELL",
"AuthorizedOfficialMiddleName": "B",
"AuthorizedOfficialTitle": "COO",
"AuthorizedOfficialNamePrefix": null,
"AuthorizedOfficialNameSuffix": "JR.",
"AuthorizedOfficialCredential": null,
"AuthorizedOfficialTelephoneNumber": "229-868-7406",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "314000000X",
"TaxonomyName": "Skilled Nursing Facility",
"LicenseNumber": "1-087-1943",
"LicenseNumberStateCode": "GA",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}