{
"Npi": {
"NPI": "1841421278",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "PARADISE VETERINARY PRACTICE PC",
"LastName": null,
"FirstName": null,
"MiddleName": null,
"NamePrefix": null,
"NameSuffix": null,
"Credential": null,
"OtherOrgName": null,
"OtherOrgNameTypeCode": null,
"OtherLastName": null,
"OtherFirstName": null,
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"OtherNamePrefix": null,
"OtherNameSuffix": null,
"OtherCredential": null,
"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "4073 WARNER ROAD",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "MARION",
"MailingAddressStateName": "NY",
"MailingAddressPostalCode": "14505-9328",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "315-926-5358",
"MailingAddressFaxNumber": "315-926-5359",
"FirstLinePracticeLocationAddress": "4073 WARNER ROAD",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "MARION",
"PracticeLocationAddressStateName": "NY",
"PracticeLocationAddressPostalCode": "14505-9328",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "315-926-5358",
"PracticeLocationAddressFaxNumber": "315-926-5359",
"EnumerationDate": "08/03/2009",
"LastUpdateDate": "08/03/2009",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "SCOVILLE",
"AuthorizedOfficialFirstName": "DAVID",
"AuthorizedOfficialMiddleName": "FARLEY",
"AuthorizedOfficialTitle": "VETERINARIAN AND OWNER OF PARADISE",
"AuthorizedOfficialNamePrefix": "DR.",
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "DVM",
"AuthorizedOfficialTelephoneNumber": "315-926-5358",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "174M00000X",
"TaxonomyName": "Veterinarian",
"LicenseNumber": "002884-1",
"LicenseNumberStateCode": "NY",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": {
"HealthcareProviderTaxonomyGroup": {
"HealthcareProviderTaxonomyGroupName": "193400000X SINGLE SPECIALTY GROUP",
"HealthcareProviderTaxonomyGroupDescription": "Single Specialty Group - A business group of one or more individual practitioners, all of who practice with the same area of specialization."
}
}
}
}