{
"Npi": {
"NPI": "1063984227",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "Y",
"ParentOrgLBN": "SAINT LUKE'S HOSPITAL OF ALLEN COUNTY, INC",
"ParentOrgTIN": null,
"OrgName": "SAINT LUKE'S HOSPITAL OF ALLEN COUNTY, 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": "403 WOODLAND HILLS BLVD",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "FORT SCOTT",
"MailingAddressStateName": "KS",
"MailingAddressPostalCode": "66701-8798",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": null,
"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "403 WOODLAND HILLS BLVD",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "FORT SCOTT",
"PracticeLocationAddressStateName": "KS",
"PracticeLocationAddressPostalCode": "66701-8798",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "620-365-1234",
"PracticeLocationAddressFaxNumber": null,
"EnumerationDate": "12/27/2018",
"LastUpdateDate": "12/17/2025",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "HARPER",
"AuthorizedOfficialFirstName": "DAMARA",
"AuthorizedOfficialMiddleName": null,
"AuthorizedOfficialTitle": "VICE PRESIDENT",
"AuthorizedOfficialNamePrefix": null,
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": null,
"AuthorizedOfficialTelephoneNumber": "816-599-9263",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "261Q00000X",
"TaxonomyName": "Clinic/Center",
"LicenseNumber": null,
"LicenseNumberStateCode": null,
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}