{
"Npi": {
"NPI": "1083706097",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "JEWEL HEALTHCARE, LLC",
"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": "PO BOX 860665",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "SHAWNEE",
"MailingAddressStateName": "KS",
"MailingAddressPostalCode": "66286-0665",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "913-631-0190",
"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "221 W LOGAN AVE",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "EMPORIA",
"PracticeLocationAddressStateName": "KS",
"PracticeLocationAddressPostalCode": "66801-4661",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "620-342-4212",
"PracticeLocationAddressFaxNumber": "620-342-6523",
"EnumerationDate": "09/28/2006",
"LastUpdateDate": "08/22/2020",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "PHILLIPS",
"AuthorizedOfficialFirstName": "JEFFREY",
"AuthorizedOfficialMiddleName": "K",
"AuthorizedOfficialTitle": "OWNER",
"AuthorizedOfficialNamePrefix": "MR.",
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": null,
"AuthorizedOfficialTelephoneNumber": "913-568-5220",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "314000000X",
"TaxonomyName": "Skilled Nursing Facility",
"LicenseNumber": "N056002",
"LicenseNumberStateCode": "KS",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}