{
"Npi": {
"NPI": "1891221206",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "TRI COUNTY HEARING AID, 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": "3519 N LECANTO HWY",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "BEVERLY HILLS",
"MailingAddressStateName": "FL",
"MailingAddressPostalCode": "34465-3501",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "352-746-1133",
"MailingAddressFaxNumber": "352-746-3474",
"FirstLinePracticeLocationAddress": "11115 SW 93RD COURT RD",
"SecondLinePracticeLocationAddress": "SUITE 600",
"PracticeLocationAddressCityName": "OCALA",
"PracticeLocationAddressStateName": "FL",
"PracticeLocationAddressPostalCode": "34481-3103",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "352-270-2944",
"PracticeLocationAddressFaxNumber": "352-228-4851",
"EnumerationDate": "05/04/2017",
"LastUpdateDate": "05/04/2017",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "DITCHFIELD",
"AuthorizedOfficialFirstName": "DAVID",
"AuthorizedOfficialMiddleName": "WAYNE",
"AuthorizedOfficialTitle": "PRESIDENT",
"AuthorizedOfficialNamePrefix": "MR.",
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "ACA, BC-HIS",
"AuthorizedOfficialTelephoneNumber": "352-746-1234",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "237700000X",
"TaxonomyName": "Hearing Instrument Specialist",
"LicenseNumber": "AS 1650",
"LicenseNumberStateCode": "FL",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": {
"HealthcareProviderTaxonomyGroup": {
"HealthcareProviderTaxonomyGroupName": "193400000X MULTIPLE 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."
}
}
}
}