{
"Npi": {
"NPI": "1275773350",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "REGINALD A. JENKINS, M.D.,P.A.",
"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": "393 BLOOMFIELD AVE",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "MONTCLAIR",
"MailingAddressStateName": "NJ",
"MailingAddressPostalCode": "07042-3505",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "973-746-8181",
"MailingAddressFaxNumber": "973-746-0599",
"FirstLinePracticeLocationAddress": "393 BLOOMFIELD AVE",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "MONTCLAIR",
"PracticeLocationAddressStateName": "NJ",
"PracticeLocationAddressPostalCode": "07042-3505",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "973-746-8181",
"PracticeLocationAddressFaxNumber": "973-746-0599",
"EnumerationDate": "03/02/2009",
"LastUpdateDate": "03/02/2009",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "JENKINS",
"AuthorizedOfficialFirstName": "REGINALD",
"AuthorizedOfficialMiddleName": "ALEXANDER",
"AuthorizedOfficialTitle": "OWNER",
"AuthorizedOfficialNamePrefix": "DR.",
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "M.D.",
"AuthorizedOfficialTelephoneNumber": "973-746-8181",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "261Q00000X",
"TaxonomyName": "Clinic/Center",
"LicenseNumber": null,
"LicenseNumberStateCode": null,
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}