{
"Npi": {
"NPI": "1255606430",
"EntityType": "Individual",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": "Y",
"IsOrgSubpart": null,
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": null,
"LastName": "FLEMING",
"FirstName": "GARRETT",
"MiddleName": "WILLIAM",
"NamePrefix": "DR.",
"NameSuffix": null,
"Credential": "D.O.",
"OtherOrgName": null,
"OtherOrgNameTypeCode": null,
"OtherLastName": null,
"OtherFirstName": null,
"OtherMiddleName": null,
"OtherNamePrefix": null,
"OtherNameSuffix": null,
"OtherCredential": null,
"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "123 HOSPITAL DR",
"SecondLineMailingAddress": "STE 2000",
"MailingAddressCityName": "WATERTOWN",
"MailingAddressStateName": "WI",
"MailingAddressPostalCode": "53098-3320",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "563-584-4100",
"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "1000 LANGWORTHY ST",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "DUBUQUE",
"PracticeLocationAddressStateName": "IA",
"PracticeLocationAddressPostalCode": "52001-7313",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "563-584-3450",
"PracticeLocationAddressFaxNumber": "563-584-3171",
"EnumerationDate": "03/20/2012",
"LastUpdateDate": "09/20/2019",
"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": "208600000X",
"TaxonomyName": "Surgery Physician",
"LicenseNumber": "DO-05037",
"LicenseNumberStateCode": "IA",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": {
"HealthcareProviderTaxonomyGroup": {
"HealthcareProviderTaxonomyGroupName": "193200000X MULTI-SPECIALTY GROUP",
"HealthcareProviderTaxonomyGroupDescription": "Multi-Specialty Group - A business group of one or more individual practitioners, who practice with different areas of specialization."
}
}
}
}