{
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"LastName": null,
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"NamePrefix": null,
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"FirstLineMailingAddress": "145 COURT ST",
"SecondLineMailingAddress": "SUITE 115",
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"MailingAddressPostalCode": "45875-1902",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "419-615-4449",
"MailingAddressFaxNumber": "844-269-8666",
"FirstLinePracticeLocationAddress": "145 COURT ST",
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"PracticeLocationAddressCityName": "OTTAWA",
"PracticeLocationAddressStateName": "OH",
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"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "419-615-4449",
"PracticeLocationAddressFaxNumber": "844-269-8666",
"EnumerationDate": "06/14/2015",
"LastUpdateDate": "05/19/2016",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "BLANKEMEIER",
"AuthorizedOfficialFirstName": "SUZANNE",
"AuthorizedOfficialMiddleName": "MARIE",
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"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "BSN, RN",
"AuthorizedOfficialTelephoneNumber": "419-615-4449",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "251E00000X",
"TaxonomyName": "Home Health Agency",
"LicenseNumber": null,
"LicenseNumberStateCode": null,
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}