{
"Npi": {
"NPI": "1912193459",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "CRAWFORD HEALTH CLINIC, 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": "PO BOX 95",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "CRAWFORD",
"MailingAddressStateName": "MS",
"MailingAddressPostalCode": "39743-0095",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "662-435-7800",
"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "15865 HIGHWAY 14",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "MACON",
"PracticeLocationAddressStateName": "MS",
"PracticeLocationAddressPostalCode": "39341",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "662-435-7800",
"PracticeLocationAddressFaxNumber": null,
"EnumerationDate": "09/19/2007",
"LastUpdateDate": "03/08/2012",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "EDWARDS",
"AuthorizedOfficialFirstName": "FELICIA",
"AuthorizedOfficialMiddleName": "DELORIS",
"AuthorizedOfficialTitle": "MANAGING PARTNER",
"AuthorizedOfficialNamePrefix": "MRS.",
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "NURSE PRACTITIONER",
"AuthorizedOfficialTelephoneNumber": "662-435-7800",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "261QR1300X",
"TaxonomyName": "Rural Health Clinic/Center",
"LicenseNumber": "R740067",
"LicenseNumberStateCode": "MS",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}