{
"Npi": {
"NPI": "1932424017",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "APEX HEART HEALTH CENTER",
"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": "502 HWY 80 W",
"SecondLineMailingAddress": "DRAWER P",
"MailingAddressCityName": "POOLER",
"MailingAddressStateName": "GA",
"MailingAddressPostalCode": "31322-2140",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "912-748-3368",
"MailingAddressFaxNumber": "912-748-6298",
"FirstLinePracticeLocationAddress": "114 CANAL ST",
"SecondLinePracticeLocationAddress": "SUITE 101",
"PracticeLocationAddressCityName": "POOLER",
"PracticeLocationAddressStateName": "GA",
"PracticeLocationAddressPostalCode": "31322-4153",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "912-748-3368",
"PracticeLocationAddressFaxNumber": "912-748-6298",
"EnumerationDate": "04/01/2010",
"LastUpdateDate": "05/07/2015",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "GORMAN",
"AuthorizedOfficialFirstName": "ALFRED",
"AuthorizedOfficialMiddleName": "CARL",
"AuthorizedOfficialTitle": "PRESIDENT",
"AuthorizedOfficialNamePrefix": "DR.",
"AuthorizedOfficialNameSuffix": "SR.",
"AuthorizedOfficialCredential": "M.D.",
"AuthorizedOfficialTelephoneNumber": "912-748-3368",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "261QM2500X",
"TaxonomyName": "Medical Specialty Clinic/Center",
"LicenseNumber": "036757",
"LicenseNumberStateCode": "GA",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}