{
"Npi": {
"NPI": "1235304981",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "ROBERT E. JOHNSON, INC.",
"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": "2579 HAMLINE AVE N",
"SecondLineMailingAddress": "SUITE D",
"MailingAddressCityName": "ROSEVILLE",
"MailingAddressStateName": "MN",
"MailingAddressPostalCode": "55113-3186",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "651-628-0947",
"MailingAddressFaxNumber": "651-636-2922",
"FirstLinePracticeLocationAddress": "2579 HAMLINE AVE N",
"SecondLinePracticeLocationAddress": "SUITE D",
"PracticeLocationAddressCityName": "ROSEVILLE",
"PracticeLocationAddressStateName": "MN",
"PracticeLocationAddressPostalCode": "55113-3186",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "651-628-0947",
"PracticeLocationAddressFaxNumber": "651-636-2922",
"EnumerationDate": "04/24/2008",
"LastUpdateDate": "04/24/2008",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "JOHNSON",
"AuthorizedOfficialFirstName": "ROBERT",
"AuthorizedOfficialMiddleName": "EDWARD",
"AuthorizedOfficialTitle": "LICENSED PSYCHOLOGIST",
"AuthorizedOfficialNamePrefix": "MR.",
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "M.A., L.P.",
"AuthorizedOfficialTelephoneNumber": "651-628-0947",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "261QM0801X",
"TaxonomyName": "Mental Health Clinic/Center (Including Community Mental Health Center)",
"LicenseNumber": "LP1796",
"LicenseNumberStateCode": "MN",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}