{
"Npi": {
"NPI": "1902228448",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "SLEEP MEDICINE SOLUTIONS, LLC",
"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": "3298 N GLASSFORD HILL RD",
"SecondLineMailingAddress": "SUITE #104-155",
"MailingAddressCityName": "PRESCOTT VALLEY",
"MailingAddressStateName": "AZ",
"MailingAddressPostalCode": "86314-1294",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "888-759-1112",
"MailingAddressFaxNumber": "877-275-2212",
"FirstLinePracticeLocationAddress": "3298 N GLASSFORD HILL RD",
"SecondLinePracticeLocationAddress": "SUITE #104-155",
"PracticeLocationAddressCityName": "PRESCOTT VALLEY",
"PracticeLocationAddressStateName": "AZ",
"PracticeLocationAddressPostalCode": "86314-1294",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "888-759-1112",
"PracticeLocationAddressFaxNumber": "877-275-2212",
"EnumerationDate": "01/17/2014",
"LastUpdateDate": "01/17/2014",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "JOHNSON",
"AuthorizedOfficialFirstName": "KORY",
"AuthorizedOfficialMiddleName": "D.",
"AuthorizedOfficialTitle": "CEO",
"AuthorizedOfficialNamePrefix": "MR.",
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "RPSGT",
"AuthorizedOfficialTelephoneNumber": "360-421-5953",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "332B00000X",
"TaxonomyName": "Durable Medical Equipment & Medical Supplies",
"LicenseNumber": "C000947",
"LicenseNumberStateCode": "AZ",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}