{
"Npi": {
"NPI": "1992830616",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "BRADLEY MEDICAL PRODUCTS INC",
"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": "PO BOX 8",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "NEWPORT BEACH",
"MailingAddressStateName": "CA",
"MailingAddressPostalCode": "92662-0008",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "949-222-2206",
"MailingAddressFaxNumber": "949-644-0070",
"FirstLinePracticeLocationAddress": "20101 SW BIRCH ST",
"SecondLinePracticeLocationAddress": "150 P",
"PracticeLocationAddressCityName": "NEWPORT BEACH",
"PracticeLocationAddressStateName": "CA",
"PracticeLocationAddressPostalCode": "92660-1748",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "949-222-2206",
"PracticeLocationAddressFaxNumber": "949-644-0070",
"EnumerationDate": "02/22/2007",
"LastUpdateDate": "04/11/2013",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "ANDERSON",
"AuthorizedOfficialFirstName": "KYLE",
"AuthorizedOfficialMiddleName": "BRADLEY",
"AuthorizedOfficialTitle": "OWNER",
"AuthorizedOfficialNamePrefix": "MR.",
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": null,
"AuthorizedOfficialTelephoneNumber": "949-378-7787",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "332B00000X",
"TaxonomyName": "Durable Medical Equipment & Medical Supplies",
"LicenseNumber": "44257",
"LicenseNumberStateCode": "CA",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}