{
"Npi": {
"NPI": "1487051645",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "SCOTT CRUSE DC PC",
"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": "1400 W NORTHWEST HWY",
"SecondLineMailingAddress": "BUEHLER YMCA",
"MailingAddressCityName": "PALATINE",
"MailingAddressStateName": "IL",
"MailingAddressPostalCode": "60067-1837",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "847-496-4567",
"MailingAddressFaxNumber": "312-419-9315",
"FirstLinePracticeLocationAddress": "1400 W NORTHWEST HWY",
"SecondLinePracticeLocationAddress": "BUEHLER YMCA",
"PracticeLocationAddressCityName": "PALATINE",
"PracticeLocationAddressStateName": "IL",
"PracticeLocationAddressPostalCode": "60067-1837",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "847-496-4567",
"PracticeLocationAddressFaxNumber": "312-419-9315",
"EnumerationDate": "12/03/2014",
"LastUpdateDate": "12/03/2014",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "CRUSE",
"AuthorizedOfficialFirstName": "SCOTT",
"AuthorizedOfficialMiddleName": "M",
"AuthorizedOfficialTitle": "CLINIC DIRECTOR",
"AuthorizedOfficialNamePrefix": null,
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "DC",
"AuthorizedOfficialTelephoneNumber": "847-496-4567",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "111N00000X",
"TaxonomyName": "Chiropractor",
"LicenseNumber": "038011574",
"LicenseNumberStateCode": "IL",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": {
"HealthcareProviderTaxonomyGroup": {
"HealthcareProviderTaxonomyGroupName": "193400000X SINGLE SPECIALTY GROUP",
"HealthcareProviderTaxonomyGroupDescription": "Single Specialty Group - A business group of one or more individual practitioners, all of who practice with the same area of specialization."
}
}
}
}