{
"Npi": {
"NPI": "1902297971",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "Y",
"ParentOrgLBN": "THE PRESBYTERIAN HOSPITAL",
"ParentOrgTIN": null,
"OrgName": "THE PRESBYTERIAN HOSPITAL",
"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": "2085 FRONTIS PLAZA BLVD",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "WINSTON SALEM",
"MailingAddressStateName": "NC",
"MailingAddressPostalCode": "27103-5614",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "336-277-7226",
"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "10030 GILEAD RD",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "HUNTERSVILLE",
"PracticeLocationAddressStateName": "NC",
"PracticeLocationAddressPostalCode": "28078-7545",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "704-316-4850",
"PracticeLocationAddressFaxNumber": null,
"EnumerationDate": "02/12/2015",
"LastUpdateDate": "02/12/2015",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "BLACKMON",
"AuthorizedOfficialFirstName": "TANYA",
"AuthorizedOfficialMiddleName": "S.",
"AuthorizedOfficialTitle": "PRESIDENT NH HUNTERSVILLE MED CTR.",
"AuthorizedOfficialNamePrefix": "MS.",
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": null,
"AuthorizedOfficialTelephoneNumber": "704-316-4037",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "261QI0500X",
"TaxonomyName": "Infusion Therapy Clinic/Center",
"LicenseNumber": "H0010",
"LicenseNumberStateCode": "NC",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}