{
"Npi": {
"NPI": "1144468448",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "NORTHFIELD URGENT CARE LLC",
"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": "2014 JEFFERSON RD STE C",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "NORTHFIELD",
"MailingAddressStateName": "MN",
"MailingAddressPostalCode": "55057-3251",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "507-664-9999",
"MailingAddressFaxNumber": "507-664-3954",
"FirstLinePracticeLocationAddress": "2014 JEFFERSON RD STE C",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "NORTHFIELD",
"PracticeLocationAddressStateName": "MN",
"PracticeLocationAddressPostalCode": "55057-3251",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "507-664-9999",
"PracticeLocationAddressFaxNumber": null,
"EnumerationDate": "01/26/2009",
"LastUpdateDate": "05/10/2010",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "BARDWELL",
"AuthorizedOfficialFirstName": "KEVIN",
"AuthorizedOfficialMiddleName": null,
"AuthorizedOfficialTitle": "OWNER/OPERATOR; PHYSICIAN PROVIDER",
"AuthorizedOfficialNamePrefix": "DR.",
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "M.D.",
"AuthorizedOfficialTelephoneNumber": "952-994-8530",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "261QU0200X",
"TaxonomyName": "Urgent Care Clinic/Center",
"LicenseNumber": "36003",
"LicenseNumberStateCode": "MN",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}