{
"Npi": {
"NPI": "1174883623",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "Y",
"ParentOrgLBN": "SAN TAN URGENT HEALTH CARE CENTER",
"ParentOrgTIN": null,
"OrgName": "SAN TAN URGENT HEALTH CARE CENTER",
"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": "21321 E OCOTILLO RD STE 118",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "QUEEN CREEK",
"MailingAddressStateName": "AZ",
"MailingAddressPostalCode": "85142-5994",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "480-458-5135",
"MailingAddressFaxNumber": "480-458-5241",
"FirstLinePracticeLocationAddress": "2081 W US HIGHWAY 70",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "THATCHER",
"PracticeLocationAddressStateName": "AZ",
"PracticeLocationAddressPostalCode": "85552-5445",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "480-458-5135",
"PracticeLocationAddressFaxNumber": "480-458-5241",
"EnumerationDate": "05/17/2012",
"LastUpdateDate": "05/17/2012",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "BROOKS",
"AuthorizedOfficialFirstName": "NATHAN",
"AuthorizedOfficialMiddleName": "MORRISON",
"AuthorizedOfficialTitle": "DOCTOR/OWNER",
"AuthorizedOfficialNamePrefix": "MR.",
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "M.D.",
"AuthorizedOfficialTelephoneNumber": "480-458-5135",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "261QU0200X",
"TaxonomyName": "Urgent Care Clinic/Center",
"LicenseNumber": "34307",
"LicenseNumberStateCode": "AZ",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}