{
"Npi": {
"NPI": "1861796799",
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"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
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"OrgName": "LYNEIL MITCHELL PHYSICAL THERAPY, PC",
"LastName": null,
"FirstName": null,
"MiddleName": null,
"NamePrefix": null,
"NameSuffix": null,
"Credential": null,
"OtherOrgName": null,
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"OtherCredential": null,
"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "20630 ROUTE 19",
"SecondLineMailingAddress": "SUITE 102",
"MailingAddressCityName": "CRANBERRY TWP",
"MailingAddressStateName": "PA",
"MailingAddressPostalCode": "16066-6021",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": null,
"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "20630 ROUTE 19",
"SecondLinePracticeLocationAddress": "SUITE 102",
"PracticeLocationAddressCityName": "CRANBERRY TWP",
"PracticeLocationAddressStateName": "PA",
"PracticeLocationAddressPostalCode": "16066-6021",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "814-881-4717",
"PracticeLocationAddressFaxNumber": null,
"EnumerationDate": "01/07/2011",
"LastUpdateDate": "01/07/2011",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "MITCHELL",
"AuthorizedOfficialFirstName": "LYNEIL",
"AuthorizedOfficialMiddleName": "CJ",
"AuthorizedOfficialTitle": "PRESIDENT",
"AuthorizedOfficialNamePrefix": "MR.",
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "DPT",
"AuthorizedOfficialTelephoneNumber": "814-881-4717",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "261QP2000X",
"TaxonomyName": "Physical Therapy Clinic/Center",
"LicenseNumber": "PT019593",
"LicenseNumberStateCode": "PA",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}