{
"Npi": {
"NPI": "1134199839",
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"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "Y",
"ParentOrgLBN": "SUMMIT HEALTHCARE ASSOCIATION",
"ParentOrgTIN": null,
"OrgName": "SUMMIT HEALTHCARE ASSOCIATION",
"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": "2200 E SHOW LOW LAKE RD",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "SHOW LOW",
"MailingAddressStateName": "AZ",
"MailingAddressPostalCode": "85901-7881",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "928-537-4375",
"MailingAddressFaxNumber": "928-537-8839",
"FirstLinePracticeLocationAddress": "2500 E HUNT DR",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "SHOW LOW",
"PracticeLocationAddressStateName": "AZ",
"PracticeLocationAddressPostalCode": "85901-7954",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "928-537-6900",
"PracticeLocationAddressFaxNumber": "928-537-8839",
"EnumerationDate": "01/25/2006",
"LastUpdateDate": "06/16/2025",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "ROTHENBERGER",
"AuthorizedOfficialFirstName": "DAVID",
"AuthorizedOfficialMiddleName": null,
"AuthorizedOfficialTitle": "CFO",
"AuthorizedOfficialNamePrefix": "MR.",
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": null,
"AuthorizedOfficialTelephoneNumber": "928-537-6399",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "251E00000X",
"TaxonomyName": "Home Health Agency",
"LicenseNumber": "HHA0032",
"LicenseNumberStateCode": "AZ",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}