{
"Npi": {
"NPI": "1902256282",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "HEARING ADVANTAGE 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": "181 S ANDERSON ST",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "RHINELANDER",
"MailingAddressStateName": "WI",
"MailingAddressPostalCode": "54501-3448",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "888-897-3711",
"MailingAddressFaxNumber": "715-420-1686",
"FirstLinePracticeLocationAddress": "2234 NEVA RD",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "ANTIGO",
"PracticeLocationAddressStateName": "WI",
"PracticeLocationAddressPostalCode": "54409-2910",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "888-897-3711",
"PracticeLocationAddressFaxNumber": "715-420-1686",
"EnumerationDate": "06/16/2016",
"LastUpdateDate": "06/16/2016",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "KASTER",
"AuthorizedOfficialFirstName": "JESSE",
"AuthorizedOfficialMiddleName": null,
"AuthorizedOfficialTitle": "OWNER",
"AuthorizedOfficialNamePrefix": null,
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": null,
"AuthorizedOfficialTelephoneNumber": "715-362-3711",
"Taxonomies": {
"Taxonomy": [
{
"TaxonomyCode": "332S00000X",
"TaxonomyName": "Hearing Aid Equipment",
"LicenseNumber": "1390060",
"LicenseNumberStateCode": "WI",
"PrimaryTaxonomySwitch": "N"
},
{
"TaxonomyCode": "332S00000X",
"TaxonomyName": "Hearing Aid Equipment",
"LicenseNumber": "1229060",
"LicenseNumberStateCode": "WI",
"PrimaryTaxonomySwitch": "Y"
}
]
},
"HealthcareProviderTaxonomyGroups": null
}
}