{
"Npi": {
"NPI": "1861766123",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "EPPS THERAPEUTIC PARTNERS CO.",
"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": "149 EVERGREEN AVE",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "BRENTWOOD",
"MailingAddressStateName": "NY",
"MailingAddressPostalCode": "11717-4100",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "631-435-0421",
"MailingAddressFaxNumber": "631-435-0421",
"FirstLinePracticeLocationAddress": "149 EVERGREEN AVE",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "BRENTWOOD",
"PracticeLocationAddressStateName": "NY",
"PracticeLocationAddressPostalCode": "11717-4100",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "631-435-0421",
"PracticeLocationAddressFaxNumber": "631-435-0421",
"EnumerationDate": "03/05/2012",
"LastUpdateDate": "03/05/2012",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "EPPS",
"AuthorizedOfficialFirstName": "DEBORAH",
"AuthorizedOfficialMiddleName": "JAMES",
"AuthorizedOfficialTitle": "CEO",
"AuthorizedOfficialNamePrefix": "MS.",
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "LCSW-R, BCD",
"AuthorizedOfficialTelephoneNumber": "631-435-0421",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "302F00000X",
"TaxonomyName": "Exclusive Provider Organization",
"LicenseNumber": "R033117",
"LicenseNumberStateCode": "NY",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}