{
"Npi": {
"NPI": "1447195078",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "NEUROLOGICAL TESTING CENTERS OF INDIANA 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": "5355 COMMERCE BLVD",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "CROWN POINT",
"MailingAddressStateName": "IN",
"MailingAddressPostalCode": "46307-5325",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "219-648-2025",
"MailingAddressFaxNumber": "219-756-0608",
"FirstLinePracticeLocationAddress": "5355 COMMERCE BLVD",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "CROWN POINT",
"PracticeLocationAddressStateName": "IN",
"PracticeLocationAddressPostalCode": "46307-5325",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "219-648-2025",
"PracticeLocationAddressFaxNumber": "219-756-0608",
"EnumerationDate": "04/21/2026",
"LastUpdateDate": "04/21/2026",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "MARLOW",
"AuthorizedOfficialFirstName": "TIM",
"AuthorizedOfficialMiddleName": null,
"AuthorizedOfficialTitle": "CEO",
"AuthorizedOfficialNamePrefix": null,
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": null,
"AuthorizedOfficialTelephoneNumber": "219-756-0600",
"Taxonomies": {
"Taxonomy": [
{
"TaxonomyCode": "367H00000X",
"TaxonomyName": "Anesthesiologist Assistant",
"LicenseNumber": null,
"LicenseNumberStateCode": null,
"PrimaryTaxonomySwitch": "N"
},
{
"TaxonomyCode": "207L00000X",
"TaxonomyName": "Anesthesiology Physician",
"LicenseNumber": null,
"LicenseNumberStateCode": null,
"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."
},
{
"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."
}
]
}
}
}