{
"Npi": {
"NPI": "1437157617",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "JACKSON COUNTY AMBULANCE SERVICE",
"LastName": null,
"FirstName": null,
"MiddleName": null,
"NamePrefix": null,
"NameSuffix": null,
"Credential": null,
"OtherOrgName": null,
"OtherOrgNameTypeCode": "6",
"OtherLastName": null,
"OtherFirstName": null,
"OtherMiddleName": null,
"OtherNamePrefix": null,
"OtherNameSuffix": null,
"OtherCredential": null,
"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "PO BOX 589",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "MADISONVILLE",
"MailingAddressStateName": "KY",
"MailingAddressPostalCode": "42431-5011",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "270-824-8123",
"MailingAddressFaxNumber": "270-824-8140",
"FirstLinePracticeLocationAddress": "1035 MCCAMMON RIDGE RD",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "MC KEE",
"PracticeLocationAddressStateName": "KY",
"PracticeLocationAddressPostalCode": "40447-6320",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "606-287-7782",
"PracticeLocationAddressFaxNumber": "606-287-4199",
"EnumerationDate": "07/12/2005",
"LastUpdateDate": "03/23/2023",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "BOWLES",
"AuthorizedOfficialFirstName": "CRAIG",
"AuthorizedOfficialMiddleName": null,
"AuthorizedOfficialTitle": "DIRECTOR / CHIEF OF OPERATIONS",
"AuthorizedOfficialNamePrefix": "MR.",
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": null,
"AuthorizedOfficialTelephoneNumber": "606-287-7782",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "3416L0300X",
"TaxonomyName": "Land Ambulance",
"LicenseNumber": "1407",
"LicenseNumberStateCode": "KY",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}