{
"Npi": {
"NPI": "1073762290",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "COUNTY OF LOGAN",
"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": "109 3RD ST",
"SecondLineMailingAddress": "P.O. BOX 508",
"MailingAddressCityName": "LINCOLN",
"MailingAddressStateName": "IL",
"MailingAddressPostalCode": "62656-2604",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "217-735-2317",
"MailingAddressFaxNumber": "217-732-6943",
"FirstLinePracticeLocationAddress": "109 3RD ST",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "LINCOLN",
"PracticeLocationAddressStateName": "IL",
"PracticeLocationAddressPostalCode": "62656-2604",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "217-735-2317",
"PracticeLocationAddressFaxNumber": "217-732-6943",
"EnumerationDate": "09/11/2008",
"LastUpdateDate": "10/19/2015",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "DAVIS",
"AuthorizedOfficialFirstName": "KARA",
"AuthorizedOfficialMiddleName": "ANN",
"AuthorizedOfficialTitle": "DIRECTOR OF NURSING/ASSISTANT ADMIN",
"AuthorizedOfficialNamePrefix": "MRS.",
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "RN, BSN",
"AuthorizedOfficialTelephoneNumber": "217-735-2317",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "251K00000X",
"TaxonomyName": "Public Health or Welfare Agency",
"LicenseNumber": null,
"LicenseNumberStateCode": null,
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}