{
"Npi": {
"NPI": "1366464182",
"EntityType": "Individual",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": "Y",
"IsOrgSubpart": null,
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": null,
"LastName": "ROCHE",
"FirstName": "ROBERT",
"MiddleName": "THOMAS",
"NamePrefix": "MR.",
"NameSuffix": "III",
"Credential": "A.T.C.",
"OtherOrgName": null,
"OtherOrgNameTypeCode": null,
"OtherLastName": null,
"OtherFirstName": null,
"OtherMiddleName": null,
"OtherNamePrefix": null,
"OtherNameSuffix": null,
"OtherCredential": null,
"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "378 BRICKYARD DR",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "CHASKA",
"MailingAddressStateName": "MN",
"MailingAddressPostalCode": "55318-2403",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "612-741-5645",
"MailingAddressFaxNumber": "952-828-6555",
"FirstLinePracticeLocationAddress": "9520 VIKING DR",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "EDEN PRAIRIE",
"PracticeLocationAddressStateName": "MN",
"PracticeLocationAddressPostalCode": "55344-3825",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "612-741-5645",
"PracticeLocationAddressFaxNumber": "952-828-6555",
"EnumerationDate": "07/24/2006",
"LastUpdateDate": "07/08/2007",
"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": "2255A2300X",
"TaxonomyName": "Athletic Trainer",
"LicenseNumber": "1939",
"LicenseNumberStateCode": "MN",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}