{"npi":"1306865563","type":"NPI-2","status":"active","name":{"display":"Custom Brace Shop Inc.","other":[],"organization_name":"CUSTOM BRACE SHOP INC.","authorised_official":"Fakhry Azer"},"specialty":{"primary_taxonomy":"332B00000X","primary_taxonomy_description":"Durable Medical Equipment & Medical Supplies","slug":"durable-medical-equipment-medical-supplies","schema_org_specialty":null,"all":[{"code":"332B00000X","description":"Durable Medical Equipment & Medical Supplies","primary":true,"state":null,"license":null}]},"addresses":[{"purpose":"LOCATION","street_1":"872 W DAYTON ST","city":"GALESBURG","state":"IL","postal_code":"614011503","country_code":"US","phone":"3093445330","fax":"3093445040"},{"purpose":"MAILING","street_1":"872 W DAYTON ST","city":"GALESBURG","state":"IL","postal_code":"614011503","country_code":"US","phone":"3093445330","fax":"3093445040"}],"license":null,"identifiers":[{"type_code":"01","label":"Other","value":"30404878","state":"IL","issuer":"CERTIFICATE OF REGISTRATI"}],"pecos":{"enrolled_at":null,"enrollments":[]},"enumeration_date":"2006-07-19","last_updated":"2008-07-11","_meta":{"source":"NPPES","snapshot_date":"2008-07-11","doc_url":"https://findmynpi.com/api"}}