{
"Npi": {
"NPI": "1396287611",
"EntityType": "Individual",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": "Y",
"IsOrgSubpart": null,
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": null,
"LastName": "RUSCH",
"FirstName": "KAYLYNN",
"MiddleName": null,
"NamePrefix": "MRS.",
"NameSuffix": null,
"Credential": "DPT",
"OtherOrgName": null,
"OtherOrgNameTypeCode": null,
"OtherLastName": "HUMPHREY",
"OtherFirstName": "KAYLYNN",
"OtherMiddleName": null,
"OtherNamePrefix": "MS.",
"OtherNameSuffix": null,
"OtherCredential": null,
"OtherLastNameTypeCode": "1",
"FirstLineMailingAddress": "W6186 CTY RD",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "PLYMOUTH",
"MailingAddressStateName": "WI",
"MailingAddressPostalCode": "53073-4639",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": null,
"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "N7135 ROCKY KNOLL PKWY",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "PLYMOUTH",
"PracticeLocationAddressStateName": "WI",
"PracticeLocationAddressPostalCode": "53073-3103",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "920-449-1254",
"PracticeLocationAddressFaxNumber": null,
"EnumerationDate": "11/17/2016",
"LastUpdateDate": "03/17/2018",
"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": "314000000X",
"TaxonomyName": "Skilled Nursing Facility",
"LicenseNumber": "13198-24",
"LicenseNumberStateCode": "WI",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}