{
"Npi": {
"NPI": "1336701960",
"EntityType": "Individual",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": "N",
"IsOrgSubpart": null,
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": null,
"LastName": "JACOBUS",
"FirstName": "AUSTIN",
"MiddleName": null,
"NamePrefix": null,
"NameSuffix": null,
"Credential": "NP",
"OtherOrgName": null,
"OtherOrgNameTypeCode": null,
"OtherLastName": null,
"OtherFirstName": null,
"OtherMiddleName": null,
"OtherNamePrefix": null,
"OtherNameSuffix": null,
"OtherCredential": null,
"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "649 VALLEY RD",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "BRIELLE",
"MailingAddressStateName": "NJ",
"MailingAddressPostalCode": "08730-1237",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "732-580-9291",
"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "18 E 41ST ST FL 12",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "NEW YORK",
"PracticeLocationAddressStateName": "NY",
"PracticeLocationAddressPostalCode": "10017-6222",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "800-254-0188",
"PracticeLocationAddressFaxNumber": null,
"EnumerationDate": "07/03/2019",
"LastUpdateDate": "07/03/2019",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": "F",
"Gender": "Female",
"AuthorizedOfficialLastName": null,
"AuthorizedOfficialFirstName": null,
"AuthorizedOfficialMiddleName": null,
"AuthorizedOfficialTitle": null,
"AuthorizedOfficialNamePrefix": null,
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": null,
"AuthorizedOfficialTelephoneNumber": null,
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "363LW0102X",
"TaxonomyName": "Women's Health Nurse Practitioner",
"LicenseNumber": "26NJ00819200",
"LicenseNumberStateCode": "NJ",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}