{
"Npi": {
"NPI": "1841490174",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "NEIL LIPSCOMB WOOD, JR, MD, 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": "11985 HERITAGE OAK PL",
"SecondLineMailingAddress": "#220",
"MailingAddressCityName": "AUBURN",
"MailingAddressStateName": "CA",
"MailingAddressPostalCode": "95603-2461",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "530-888-6322",
"MailingAddressFaxNumber": "530-888-6338",
"FirstLinePracticeLocationAddress": "11985 HERITAGE OAK PL",
"SecondLinePracticeLocationAddress": "#220",
"PracticeLocationAddressCityName": "AUBURN",
"PracticeLocationAddressStateName": "CA",
"PracticeLocationAddressPostalCode": "95603-2461",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "530-888-6322",
"PracticeLocationAddressFaxNumber": "530-888-6338",
"EnumerationDate": "07/24/2007",
"LastUpdateDate": "12/11/2018",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "WOOD",
"AuthorizedOfficialFirstName": "NEIL",
"AuthorizedOfficialMiddleName": "LIPSCOMB",
"AuthorizedOfficialTitle": "PRESIDENT",
"AuthorizedOfficialNamePrefix": null,
"AuthorizedOfficialNameSuffix": "JR.",
"AuthorizedOfficialCredential": "MD",
"AuthorizedOfficialTelephoneNumber": "530-888-6322",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "261QM2500X",
"TaxonomyName": "Medical Specialty Clinic/Center",
"LicenseNumber": "C36813",
"LicenseNumberStateCode": "CA",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}