{
"Npi": {
"NPI": "1386795623",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "PELLA CSD",
"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": "210 E UNIVERSITY ST",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "PELLA",
"MailingAddressStateName": "IA",
"MailingAddressPostalCode": "50219-1970",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "641-628-1111",
"MailingAddressFaxNumber": "641-628-1116",
"FirstLinePracticeLocationAddress": "210 E UNIVERSITY ST",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "PELLA",
"PracticeLocationAddressStateName": "IA",
"PracticeLocationAddressPostalCode": "50219-1970",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "641-628-1111",
"PracticeLocationAddressFaxNumber": "641-628-1116",
"EnumerationDate": "01/15/2007",
"LastUpdateDate": "08/22/2020",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "WITTMER",
"AuthorizedOfficialFirstName": "MARK",
"AuthorizedOfficialMiddleName": "J",
"AuthorizedOfficialTitle": "SUPERINTENDENT",
"AuthorizedOfficialNamePrefix": null,
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": null,
"AuthorizedOfficialTelephoneNumber": "641-628-1111",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "251300000X",
"TaxonomyName": "Local Education Agency (LEA)",
"LicenseNumber": null,
"LicenseNumberStateCode": "IA",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}