{
"Npi": {
"NPI": "1093849481",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "GRUNDY COUNTY HEALTH DEPT",
"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": "1716 LINCOLN ST",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "TRENTON",
"MailingAddressStateName": "MO",
"MailingAddressPostalCode": "64683-1584",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "660-359-4196",
"MailingAddressFaxNumber": "660-359-5470",
"FirstLinePracticeLocationAddress": "1716 LINCOLN ST",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "TRENTON",
"PracticeLocationAddressStateName": "MO",
"PracticeLocationAddressPostalCode": "64683-1584",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "660-359-4196",
"PracticeLocationAddressFaxNumber": "660-359-5470",
"EnumerationDate": "03/15/2007",
"LastUpdateDate": "11/21/2022",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "GIBSON",
"AuthorizedOfficialFirstName": "ELIZABETH",
"AuthorizedOfficialMiddleName": null,
"AuthorizedOfficialTitle": "ADMINISTRATOR",
"AuthorizedOfficialNamePrefix": null,
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": null,
"AuthorizedOfficialTelephoneNumber": "660-359-4196",
"Taxonomies": {
"Taxonomy": [
{
"TaxonomyCode": "251K00000X",
"TaxonomyName": "Public Health or Welfare Agency",
"LicenseNumber": null,
"LicenseNumberStateCode": null,
"PrimaryTaxonomySwitch": "N"
},
{
"TaxonomyCode": "251K00000X",
"TaxonomyName": "Public Health or Welfare Agency",
"LicenseNumber": "14277883",
"LicenseNumberStateCode": "MO",
"PrimaryTaxonomySwitch": "Y"
}
]
},
"HealthcareProviderTaxonomyGroups": null
}
}