{
"Npi": {
"NPI": "1952672339",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "HEARING AID ASSOCIATES, 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": "25255 GRAVEL HILL RD",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "MILLSBORO",
"MailingAddressStateName": "DE",
"MailingAddressPostalCode": "19966-3468",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "302-934-1471",
"MailingAddressFaxNumber": "302-934-9687",
"FirstLinePracticeLocationAddress": "25255 GRAVEL HILL RD",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "MILLSBORO",
"PracticeLocationAddressStateName": "DE",
"PracticeLocationAddressPostalCode": "19966-3468",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "302-934-1471",
"PracticeLocationAddressFaxNumber": "302-934-9687",
"EnumerationDate": "01/18/2012",
"LastUpdateDate": "01/19/2012",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "FAVINGER",
"AuthorizedOfficialFirstName": "MATTHEW",
"AuthorizedOfficialMiddleName": "TODD",
"AuthorizedOfficialTitle": "AUDIOLOGIST",
"AuthorizedOfficialNamePrefix": "MR.",
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "M.S. F-AAA",
"AuthorizedOfficialTelephoneNumber": "302-934-1471",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "231H00000X",
"TaxonomyName": "Audiologist",
"LicenseNumber": "02-0000122",
"LicenseNumberStateCode": "DE",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": {
"HealthcareProviderTaxonomyGroup": {
"HealthcareProviderTaxonomyGroupName": "193400000X SINGLE SPECIALTY GROUP",
"HealthcareProviderTaxonomyGroupDescription": "Single Specialty Group - A business group of one or more individual practitioners, all of who practice with the same area of specialization."
}
}
}
}