{
"Npi": {
"NPI": "1265479950",
"EntityType": "Individual",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": "Y",
"IsOrgSubpart": null,
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": null,
"LastName": "BUTLER",
"FirstName": "BRADLEY",
"MiddleName": "STEVEN",
"NamePrefix": null,
"NameSuffix": null,
"Credential": "MD",
"OtherOrgName": null,
"OtherOrgNameTypeCode": null,
"OtherLastName": null,
"OtherFirstName": null,
"OtherMiddleName": null,
"OtherNamePrefix": null,
"OtherNameSuffix": null,
"OtherCredential": null,
"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "5086 E ROMA AVE",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "PHOENIX",
"MailingAddressStateName": "AZ",
"MailingAddressPostalCode": "85018-4435",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "602-741-6321",
"MailingAddressFaxNumber": "602-466-1763",
"FirstLinePracticeLocationAddress": "8901 WISCONSIN AVE BLDG 9A",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "BETHESDA",
"PracticeLocationAddressStateName": "MD",
"PracticeLocationAddressPostalCode": "20889-0004",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "602-741-6321",
"PracticeLocationAddressFaxNumber": null,
"EnumerationDate": "06/01/2006",
"LastUpdateDate": "02/26/2025",
"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": "207P00000X",
"TaxonomyName": "Emergency Medicine Physician",
"LicenseNumber": "23431",
"LicenseNumberStateCode": "AZ",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}