{
"Npi": {
"NPI": "1407395734",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "INFINITY CARE HOUSECALL AND NURSING SERVICES",
"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": "11331 183RD ST # 178",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "CERRITOS",
"MailingAddressStateName": "CA",
"MailingAddressPostalCode": "90703-5434",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "818-322-7536",
"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "3300 E SOUTH ST STE 209",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "LAKEWOOD",
"PracticeLocationAddressStateName": "CA",
"PracticeLocationAddressPostalCode": "90805-4592",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "818-322-7536",
"PracticeLocationAddressFaxNumber": null,
"EnumerationDate": "02/20/2017",
"LastUpdateDate": "05/04/2017",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "YARASHEVICH",
"AuthorizedOfficialFirstName": "EDNA",
"AuthorizedOfficialMiddleName": null,
"AuthorizedOfficialTitle": "NP/VICE PRESIDENT",
"AuthorizedOfficialNamePrefix": null,
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "NP",
"AuthorizedOfficialTelephoneNumber": "818-322-7536",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "363L00000X",
"TaxonomyName": "Nurse Practitioner",
"LicenseNumber": "95001399",
"LicenseNumberStateCode": "CA",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": {
"HealthcareProviderTaxonomyGroup": {
"HealthcareProviderTaxonomyGroupName": "193200000X MULTI-SPECIALTY GROUP",
"HealthcareProviderTaxonomyGroupDescription": "Multi-Specialty Group - A business group of one or more individual practitioners, who practice with different areas of specialization."
}
}
}
}