{
"Npi": {
"NPI": "1063017754",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "OVER THE TOP SERVICES AND CARE, INC.",
"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": "345 PONCE HARBOR DR APT 104",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "SAINT AUGUSTINE",
"MailingAddressStateName": "FL",
"MailingAddressPostalCode": "32086-5115",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "904-522-3118",
"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "345 PONCE HARBOR DR APT 104",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "SAINT AUGUSTINE",
"PracticeLocationAddressStateName": "FL",
"PracticeLocationAddressPostalCode": "32086-5115",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "904-522-3118",
"PracticeLocationAddressFaxNumber": null,
"EnumerationDate": "12/01/2020",
"LastUpdateDate": "04/21/2022",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "BLOUNT",
"AuthorizedOfficialFirstName": "UREKA",
"AuthorizedOfficialMiddleName": null,
"AuthorizedOfficialTitle": "CEO",
"AuthorizedOfficialNamePrefix": null,
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": null,
"AuthorizedOfficialTelephoneNumber": "904-522-3118",
"Taxonomies": {
"Taxonomy": [
{
"TaxonomyCode": "372600000X",
"TaxonomyName": "Adult Companion",
"LicenseNumber": null,
"LicenseNumberStateCode": null,
"PrimaryTaxonomySwitch": "N"
},
{
"TaxonomyCode": "376J00000X",
"TaxonomyName": "Homemaker",
"LicenseNumber": null,
"LicenseNumberStateCode": null,
"PrimaryTaxonomySwitch": "N"
},
{
"TaxonomyCode": "3747A0650X",
"TaxonomyName": "Attendant Care Provider",
"LicenseNumber": null,
"LicenseNumberStateCode": null,
"PrimaryTaxonomySwitch": "Y"
}
]
},
"HealthcareProviderTaxonomyGroups": {
"HealthcareProviderTaxonomyGroup": [
{
"HealthcareProviderTaxonomyGroupName": "193400000X MULTIPLE 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."
},
{
"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."
},
{
"HealthcareProviderTaxonomyGroupName": "193200000X MULTI-SPECIALTY GROUP",
"HealthcareProviderTaxonomyGroupDescription": "Multi-Specialty Group - A business group of one or more individual practitioners, who practice with different areas of specialization."
}
]
}
}
}