{
"Npi": {
"NPI": "1104089556",
"EntityType": "Individual",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": "N",
"IsOrgSubpart": null,
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": null,
"LastName": "BITTERS",
"FirstName": "J'CINDA",
"MiddleName": "J'NAE",
"NamePrefix": "MISS",
"NameSuffix": null,
"Credential": "MD",
"OtherOrgName": null,
"OtherOrgNameTypeCode": null,
"OtherLastName": "RODGERS",
"OtherFirstName": "J'CINDA",
"OtherMiddleName": "J'NAE",
"OtherNamePrefix": null,
"OtherNameSuffix": null,
"OtherCredential": null,
"OtherLastNameTypeCode": "1",
"FirstLineMailingAddress": "211 E LOGAN ST STE 301",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "CALDWELL",
"MailingAddressStateName": "ID",
"MailingAddressPostalCode": "83605-4882",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "208-459-4667",
"MailingAddressFaxNumber": "208-459-3372",
"FirstLinePracticeLocationAddress": "211 E LOGAN ST STE 301",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "CALDWELL",
"PracticeLocationAddressStateName": "ID",
"PracticeLocationAddressPostalCode": "83605-4882",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "208-459-4667",
"PracticeLocationAddressFaxNumber": "208-459-3372",
"EnumerationDate": "07/07/2008",
"LastUpdateDate": "01/27/2022",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": "F",
"Gender": "Female",
"AuthorizedOfficialLastName": null,
"AuthorizedOfficialFirstName": null,
"AuthorizedOfficialMiddleName": null,
"AuthorizedOfficialTitle": null,
"AuthorizedOfficialNamePrefix": null,
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": null,
"AuthorizedOfficialTelephoneNumber": null,
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "207Q00000X",
"TaxonomyName": "Family Medicine Physician",
"LicenseNumber": "M-10839",
"LicenseNumberStateCode": "ID",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}