{
"Npi": {
"NPI": "1972611143",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "ALPHA OMEGA HOSPICE LP",
"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": "500 FAULCONER DR STE 200",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "CHARLOTTESVILLE",
"MailingAddressStateName": "VA",
"MailingAddressPostalCode": "22903-5089",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "434-977-9711",
"MailingAddressFaxNumber": "434-235-4142",
"FirstLinePracticeLocationAddress": "941 HILLTOP DR",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "WEATHERFORD",
"PracticeLocationAddressStateName": "TX",
"PracticeLocationAddressPostalCode": "76086-5845",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "817-238-0770",
"PracticeLocationAddressFaxNumber": "817-238-0786",
"EnumerationDate": "08/28/2006",
"LastUpdateDate": "05/12/2025",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "MOORE",
"AuthorizedOfficialFirstName": "JESSE",
"AuthorizedOfficialMiddleName": "R",
"AuthorizedOfficialTitle": "CHIEF ADMINISTRATIVE OFFICER",
"AuthorizedOfficialNamePrefix": null,
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": null,
"AuthorizedOfficialTelephoneNumber": "857-331-6271",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "251G00000X",
"TaxonomyName": "Community Based Hospice Care Agency",
"LicenseNumber": "009222",
"LicenseNumberStateCode": "TX",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}