{
"Npi": {
"NPI": "1881861706",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "P. JOSHUA MAMMEN M.D. A.P.M.C",
"LastName": null,
"FirstName": null,
"MiddleName": null,
"NamePrefix": null,
"NameSuffix": null,
"Credential": null,
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"OtherOrgNameTypeCode": null,
"OtherLastName": null,
"OtherFirstName": null,
"OtherMiddleName": null,
"OtherNamePrefix": null,
"OtherNameSuffix": null,
"OtherCredential": null,
"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "711 N MONTGOMERY AVE",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "KAPLAN",
"MailingAddressStateName": "LA",
"MailingAddressPostalCode": "70548-2923",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "337-643-1747",
"MailingAddressFaxNumber": "337-643-3707",
"FirstLinePracticeLocationAddress": "713 N EASTERN AVE",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "CROWLEY",
"PracticeLocationAddressStateName": "LA",
"PracticeLocationAddressPostalCode": "70526-3856",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "337-788-2216",
"PracticeLocationAddressFaxNumber": "337-783-9407",
"EnumerationDate": "05/09/2008",
"LastUpdateDate": "06/09/2008",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "MAMMEN",
"AuthorizedOfficialFirstName": "JOSHUA",
"AuthorizedOfficialMiddleName": "P",
"AuthorizedOfficialTitle": "GENERAL SURGEON/OWNER",
"AuthorizedOfficialNamePrefix": "DR.",
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "M.D.",
"AuthorizedOfficialTelephoneNumber": "337-788-2216",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "208600000X",
"TaxonomyName": "Surgery Physician",
"LicenseNumber": "05428R",
"LicenseNumberStateCode": "LA",
"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."
}
}
}
}