{
"Npi": {
"NPI": "1891176517",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "HAL MEDICAL O&P, PC",
"LastName": null,
"FirstName": null,
"MiddleName": null,
"NamePrefix": null,
"NameSuffix": null,
"Credential": null,
"OtherOrgName": null,
"OtherOrgNameTypeCode": null,
"OtherLastName": null,
"OtherFirstName": null,
"OtherMiddleName": null,
"OtherNamePrefix": null,
"OtherNameSuffix": null,
"OtherCredential": null,
"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "2245 COUNTY ROAD 93",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "ANDERSON",
"MailingAddressStateName": "AL",
"MailingAddressPostalCode": "35610-4125",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "256-444-4740",
"MailingAddressFaxNumber": "256-230-2323",
"FirstLinePracticeLocationAddress": "22923 US HIGHWAY 72 STE A",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "ATHENS",
"PracticeLocationAddressStateName": "AL",
"PracticeLocationAddressPostalCode": "35613-7618",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "256-230-2321",
"PracticeLocationAddressFaxNumber": "256-444-4422",
"EnumerationDate": "06/18/2015",
"LastUpdateDate": "03/10/2020",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "BERRYHILL",
"AuthorizedOfficialFirstName": "JONATHAN",
"AuthorizedOfficialMiddleName": "RICHARD",
"AuthorizedOfficialTitle": "CEO",
"AuthorizedOfficialNamePrefix": "MR.",
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": null,
"AuthorizedOfficialTelephoneNumber": "256-444-4740",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "335E00000X",
"TaxonomyName": "Prosthetic/Orthotic Supplier",
"LicenseNumber": "612",
"LicenseNumberStateCode": "AL",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}