{
"Npi": {
"NPI": "1215988357",
"EntityType": "Individual",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": "N",
"IsOrgSubpart": null,
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": null,
"LastName": "MITCHELL",
"FirstName": "MICHAEL",
"MiddleName": null,
"NamePrefix": null,
"NameSuffix": null,
"Credential": "M.D.",
"OtherOrgName": null,
"OtherOrgNameTypeCode": null,
"OtherLastName": null,
"OtherFirstName": null,
"OtherMiddleName": null,
"OtherNamePrefix": null,
"OtherNameSuffix": null,
"OtherCredential": null,
"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "2606 CENTENNIAL PL",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "TALLAHASSEE",
"MailingAddressStateName": "FL",
"MailingAddressPostalCode": "32308-0572",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "850-205-0189",
"MailingAddressFaxNumber": "850-329-2903",
"FirstLinePracticeLocationAddress": "2606 CENTENNIAL PL",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "TALLAHASSEE",
"PracticeLocationAddressStateName": "FL",
"PracticeLocationAddressPostalCode": "32308-0572",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "850-205-0189",
"PracticeLocationAddressFaxNumber": "850-329-2903",
"EnumerationDate": "05/13/2006",
"LastUpdateDate": "07/05/2021",
"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": "2084P0800X",
"TaxonomyName": "Psychiatry Physician",
"LicenseNumber": "ME0088446",
"LicenseNumberStateCode": "FL",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}