{
"Npi": {
"NPI": "1245763838",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "KIND HEART PHLEBOTOMY",
"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": "PO BOX 11226",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "MERRILLVILLE",
"MailingAddressStateName": "IN",
"MailingAddressPostalCode": "46411",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "121-988-8981",
"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "1100 E 56TH AVE",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "MERRILLVILLE",
"PracticeLocationAddressStateName": "IN",
"PracticeLocationAddressPostalCode": "46410-1726",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "121-947-2227",
"PracticeLocationAddressFaxNumber": null,
"EnumerationDate": "04/10/2017",
"LastUpdateDate": "04/10/2017",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "MCDUFFIE",
"AuthorizedOfficialFirstName": "TYSHARON",
"AuthorizedOfficialMiddleName": null,
"AuthorizedOfficialTitle": "PHLEBOTOMIST/OWNER",
"AuthorizedOfficialNamePrefix": null,
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "PHLEBOTOMIST",
"AuthorizedOfficialTelephoneNumber": "219-776-0883",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "291U00000X",
"TaxonomyName": "Clinical Medical Laboratory",
"LicenseNumber": null,
"LicenseNumberStateCode": "IN",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}