{
"Npi": {
"NPI": "1154553154",
"EntityType": "Individual",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": "Y",
"IsOrgSubpart": null,
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": null,
"LastName": "JENKINS",
"FirstName": "TASHA",
"MiddleName": "Y",
"NamePrefix": "DR.",
"NameSuffix": null,
"Credential": "M.D.",
"OtherOrgName": null,
"OtherOrgNameTypeCode": null,
"OtherLastName": null,
"OtherFirstName": null,
"OtherMiddleName": null,
"OtherNamePrefix": null,
"OtherNameSuffix": null,
"OtherCredential": null,
"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "4405 N HOLLAND SYLVANIA RD",
"SecondLineMailingAddress": "SUITE 104",
"MailingAddressCityName": "TOLEDO",
"MailingAddressStateName": "OH",
"MailingAddressPostalCode": "43623-3529",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "419-882-6784",
"MailingAddressFaxNumber": "419-882-4795",
"FirstLinePracticeLocationAddress": "7302 JACKMAN RD",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "TEMPERANCE",
"PracticeLocationAddressStateName": "MI",
"PracticeLocationAddressPostalCode": "48182-1315",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "734-850-8902",
"PracticeLocationAddressFaxNumber": null,
"EnumerationDate": "08/10/2009",
"LastUpdateDate": "02/12/2010",
"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": "4301093861",
"LicenseNumberStateCode": "MI",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}