{
"Npi": {
"NPI": "1437511821",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "JESSE AMBULANCE SERVICE LLC",
"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": "201 E. HOLT",
"SecondLineMailingAddress": "PO BOX 41",
"MailingAddressCityName": "BROADUS",
"MailingAddressStateName": "MT",
"MailingAddressPostalCode": "59317",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "406-436-2225",
"MailingAddressFaxNumber": "406-436-2033",
"FirstLinePracticeLocationAddress": "201 E. HOLT STREET",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "BROADUS",
"PracticeLocationAddressStateName": "MT",
"PracticeLocationAddressPostalCode": "59317-0041",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "406-436-2225",
"PracticeLocationAddressFaxNumber": "406-436-2033",
"EnumerationDate": "03/24/2016",
"LastUpdateDate": "03/24/2016",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "JESSE",
"AuthorizedOfficialFirstName": "RICHARD",
"AuthorizedOfficialMiddleName": "G.",
"AuthorizedOfficialTitle": "ORGANIZER",
"AuthorizedOfficialNamePrefix": "MR.",
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "EMT",
"AuthorizedOfficialTelephoneNumber": "605-939-5668",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "3416L0300X",
"TaxonomyName": "Land Ambulance",
"LicenseNumber": "446",
"LicenseNumberStateCode": "MT",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}