{
"Npi": {
"NPI": "1265230874",
"EntityType": "Individual",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": "N",
"IsOrgSubpart": null,
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": null,
"LastName": "TAPP",
"FirstName": "PATRICK",
"MiddleName": "YVAN",
"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": "510 HUSET PKWY NE",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "COLUMBIA HEIGHTS",
"MailingAddressStateName": "MN",
"MailingAddressPostalCode": "55421-5030",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "612-812-0286",
"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "7505 METRO BLVD STE 505",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "EDINA",
"PracticeLocationAddressStateName": "MN",
"PracticeLocationAddressPostalCode": "55439-3018",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "651-271-1665",
"PracticeLocationAddressFaxNumber": null,
"EnumerationDate": "03/07/2025",
"LastUpdateDate": "09/29/2025",
"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": "363LP0808X",
"TaxonomyName": "Psychiatric/Mental Health Nurse Practitioner",
"LicenseNumber": "13129",
"LicenseNumberStateCode": "MN",
"PrimaryTaxonomySwitch": "Y"
},
{
"TaxonomyCode": "163WP0808X",
"TaxonomyName": "Psychiatric/Mental Health Registered Nurse",
"LicenseNumber": "2476128",
"LicenseNumberStateCode": "MN",
"PrimaryTaxonomySwitch": "N"
}
]
},
"HealthcareProviderTaxonomyGroups": null
}
}