{
"Npi": {
"NPI": "1093047425",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "KELLY ANGELL",
"LastName": null,
"FirstName": null,
"MiddleName": null,
"NamePrefix": null,
"NameSuffix": null,
"Credential": null,
"OtherOrgName": null,
"OtherOrgNameTypeCode": null,
"OtherLastName": null,
"OtherFirstName": null,
"OtherMiddleName": null,
"OtherNamePrefix": null,
"OtherNameSuffix": null,
"OtherCredential": null,
"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "5239 RANDALL HILL RD",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "TRUXTON",
"MailingAddressStateName": "NY",
"MailingAddressPostalCode": "13158",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "160-784-2641",
"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "5239 RANDALL HILL RD",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "TRUXTON",
"PracticeLocationAddressStateName": "NY",
"PracticeLocationAddressPostalCode": "13158-4208",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "160-784-2641",
"PracticeLocationAddressFaxNumber": null,
"EnumerationDate": "02/10/2010",
"LastUpdateDate": "02/10/2010",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "ANGELL",
"AuthorizedOfficialFirstName": "KELLY",
"AuthorizedOfficialMiddleName": "G",
"AuthorizedOfficialTitle": "LPN",
"AuthorizedOfficialNamePrefix": null,
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": null,
"AuthorizedOfficialTelephoneNumber": "607-842-6419",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "251J00000X",
"TaxonomyName": "Nursing Care Agency",
"LicenseNumber": "294888-1",
"LicenseNumberStateCode": "NY",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}