{
"Npi": {
"NPI": "1952695397",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "BENJAMIN O. AKIWUMI, MD",
"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": "PO BOX 1579",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "BURGAW",
"MailingAddressStateName": "NC",
"MailingAddressPostalCode": "28425-1579",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "910-300-9220",
"MailingAddressFaxNumber": "910-300-9270",
"FirstLinePracticeLocationAddress": "105 W COURTHOUSE AVE",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "BURGAW",
"PracticeLocationAddressStateName": "NC",
"PracticeLocationAddressPostalCode": "28425-0000",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "910-300-9220",
"PracticeLocationAddressFaxNumber": "910-300-9270",
"EnumerationDate": "06/02/2011",
"LastUpdateDate": "03/14/2012",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "AKIWUMI",
"AuthorizedOfficialFirstName": "BENJAMIN",
"AuthorizedOfficialMiddleName": "OLUFEMI",
"AuthorizedOfficialTitle": "MEDICAL DIRECTOR",
"AuthorizedOfficialNamePrefix": null,
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "M.D.",
"AuthorizedOfficialTelephoneNumber": "910-300-9220",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "207R00000X",
"TaxonomyName": "Internal Medicine Physician",
"LicenseNumber": "9900005",
"LicenseNumberStateCode": "NC",
"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."
}
}
}
}