{
"Npi": {
"NPI": "1497952535",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "INDEPENDENCE VOLUNTEER RESCUE SQUAD INC.",
"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": "PO BOX 9150",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "PADUCAH",
"MailingAddressStateName": "KY",
"MailingAddressPostalCode": "42002-9150",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "270-744-8413",
"MailingAddressFaxNumber": "270-744-8642",
"FirstLinePracticeLocationAddress": "182 WEST MAIN STREET",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "INDEPENDENCE",
"PracticeLocationAddressStateName": "VA",
"PracticeLocationAddressPostalCode": "24348-4365",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "276-773-3343",
"PracticeLocationAddressFaxNumber": "276-773-3035",
"EnumerationDate": "07/02/2007",
"LastUpdateDate": "06/16/2021",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "BOYER",
"AuthorizedOfficialFirstName": "MELAINE",
"AuthorizedOfficialMiddleName": "O",
"AuthorizedOfficialTitle": "CAPTAIN",
"AuthorizedOfficialNamePrefix": null,
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": null,
"AuthorizedOfficialTelephoneNumber": "276-768-8558",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "3416L0300X",
"TaxonomyName": "Land Ambulance",
"LicenseNumber": "198",
"LicenseNumberStateCode": "VA",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}