{
"Npi": {
"NPI": "1477149003",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "B-KONNECTED, LLC",
"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 40472",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "DENVER",
"MailingAddressStateName": "CO",
"MailingAddressPostalCode": "80204-0472",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "419-605-2738",
"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "3615 S HURON ST STE 206",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "ENGLEWOOD",
"PracticeLocationAddressStateName": "CO",
"PracticeLocationAddressPostalCode": "80110-3494",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "720-551-7441",
"PracticeLocationAddressFaxNumber": null,
"EnumerationDate": "12/17/2020",
"LastUpdateDate": "06/29/2021",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "KATALENAS",
"AuthorizedOfficialFirstName": "BRITTANY",
"AuthorizedOfficialMiddleName": "MARY",
"AuthorizedOfficialTitle": "CEO",
"AuthorizedOfficialNamePrefix": null,
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "MSW",
"AuthorizedOfficialTelephoneNumber": "419-605-2738",
"Taxonomies": {
"Taxonomy": [
{
"TaxonomyCode": "251B00000X",
"TaxonomyName": "Case Management Agency",
"LicenseNumber": null,
"LicenseNumberStateCode": null,
"PrimaryTaxonomySwitch": "N"
},
{
"TaxonomyCode": "261QM1300X",
"TaxonomyName": "Multi-Specialty Clinic/Center",
"LicenseNumber": null,
"LicenseNumberStateCode": null,
"PrimaryTaxonomySwitch": "Y"
}
]
},
"HealthcareProviderTaxonomyGroups": null
}
}