{
"Npi": {
"NPI": "1932195195",
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"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "RODNEY D. HENSON",
"LastName": null,
"FirstName": null,
"MiddleName": null,
"NamePrefix": null,
"NameSuffix": null,
"Credential": null,
"OtherOrgName": null,
"OtherOrgNameTypeCode": "6",
"OtherLastName": null,
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"OtherNamePrefix": null,
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"OtherCredential": null,
"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "2540 PACIFIC AVE",
"SecondLineMailingAddress": "SUITE 2B",
"MailingAddressCityName": "STOCKTON",
"MailingAddressStateName": "CA",
"MailingAddressPostalCode": "95204-4400",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "209-944-9990",
"MailingAddressFaxNumber": "209-944-9992",
"FirstLinePracticeLocationAddress": "2540 PACIFIC AVE",
"SecondLinePracticeLocationAddress": "SUITE 2B",
"PracticeLocationAddressCityName": "STOCKTON",
"PracticeLocationAddressStateName": "CA",
"PracticeLocationAddressPostalCode": "95204-4400",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "209-944-9990",
"PracticeLocationAddressFaxNumber": "209-944-9992",
"EnumerationDate": "09/23/2005",
"LastUpdateDate": "09/08/2015",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "HENSON",
"AuthorizedOfficialFirstName": "RODNEY",
"AuthorizedOfficialMiddleName": "DOUGLAS",
"AuthorizedOfficialTitle": "OWNER",
"AuthorizedOfficialNamePrefix": "MR.",
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "CPO 02313",
"AuthorizedOfficialTelephoneNumber": "209-944-9990",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "335E00000X",
"TaxonomyName": "Prosthetic/Orthotic Supplier",
"LicenseNumber": null,
"LicenseNumberStateCode": null,
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}