{
"Npi": {
"NPI": "1114219953",
"EntityType": "Individual",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": "Y",
"IsOrgSubpart": null,
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": null,
"LastName": "VOGEL",
"FirstName": "MICHAEL",
"MiddleName": "JOSEPH",
"NamePrefix": "DR.",
"NameSuffix": null,
"Credential": "PSY.D.",
"OtherOrgName": null,
"OtherOrgNameTypeCode": null,
"OtherLastName": null,
"OtherFirstName": null,
"OtherMiddleName": null,
"OtherNamePrefix": null,
"OtherNameSuffix": null,
"OtherCredential": null,
"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "500 S COBB ST UNIT 3610",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "PALMER",
"MailingAddressStateName": "AK",
"MailingAddressPostalCode": "99645-1399",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "907-921-1293",
"MailingAddressFaxNumber": "907-416-5455",
"FirstLinePracticeLocationAddress": "13036 OLD GLENN HWY",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "EAGLE RIVER",
"PracticeLocationAddressStateName": "AK",
"PracticeLocationAddressPostalCode": "99577-7566",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "907-921-1293",
"PracticeLocationAddressFaxNumber": "907-416-5455",
"EnumerationDate": "05/12/2011",
"LastUpdateDate": "11/17/2022",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": "M",
"Gender": "Male",
"AuthorizedOfficialLastName": null,
"AuthorizedOfficialFirstName": null,
"AuthorizedOfficialMiddleName": null,
"AuthorizedOfficialTitle": null,
"AuthorizedOfficialNamePrefix": null,
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": null,
"AuthorizedOfficialTelephoneNumber": null,
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "103TC0700X",
"TaxonomyName": "Clinical Psychologist",
"LicenseNumber": "196899",
"LicenseNumberStateCode": "AK",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}