{
"Npi": {
"NPI": "1245783778",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "RICHARDS CHIROPRACTIC LLC",
"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": "16645 W GREENFIELD AVE",
"SecondLineMailingAddress": "SUITE D",
"MailingAddressCityName": "NEW BERLIN",
"MailingAddressStateName": "WI",
"MailingAddressPostalCode": "53151-1424",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "262-788-5940",
"MailingAddressFaxNumber": "262-788-5986",
"FirstLinePracticeLocationAddress": "16645 W GREENFIELD AVE",
"SecondLinePracticeLocationAddress": "SUITE D",
"PracticeLocationAddressCityName": "NEW BERLIN",
"PracticeLocationAddressStateName": "WI",
"PracticeLocationAddressPostalCode": "53151-1424",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "262-788-5940",
"PracticeLocationAddressFaxNumber": "262-788-5986",
"EnumerationDate": "08/02/2016",
"LastUpdateDate": "08/02/2016",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "RICHARDS",
"AuthorizedOfficialFirstName": "JESSICA",
"AuthorizedOfficialMiddleName": "LYNN",
"AuthorizedOfficialTitle": "CHIROPRACTOR",
"AuthorizedOfficialNamePrefix": "DR.",
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": null,
"AuthorizedOfficialTelephoneNumber": "262-788-5940",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "261QP2300X",
"TaxonomyName": "Primary Care Clinic/Center",
"LicenseNumber": "5198-12",
"LicenseNumberStateCode": "WI",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}