{
"Npi": {
"NPI": "1528642618",
"EntityType": "Individual",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": "N",
"IsOrgSubpart": null,
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": null,
"LastName": "OKWUDILI",
"FirstName": "EMEKA",
"MiddleName": "S",
"NamePrefix": null,
"NameSuffix": null,
"Credential": "MD",
"OtherOrgName": null,
"OtherOrgNameTypeCode": null,
"OtherLastName": null,
"OtherFirstName": null,
"OtherMiddleName": null,
"OtherNamePrefix": null,
"OtherNameSuffix": null,
"OtherCredential": null,
"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "UCONN SCHOOL OF MEDICINE-GRADUATE MEDICAL EDUCATION",
"SecondLineMailingAddress": "263 FARMINGTON AVENUE -LM068",
"MailingAddressCityName": "FARMINGTON",
"MailingAddressStateName": "CT",
"MailingAddressPostalCode": "06030-1921",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "860-679-2147",
"MailingAddressFaxNumber": "860-679-4684",
"FirstLinePracticeLocationAddress": "901 2ND ST",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "LANGDON",
"PracticeLocationAddressStateName": "ND",
"PracticeLocationAddressPostalCode": "58249-2407",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "701-256-6120",
"PracticeLocationAddressFaxNumber": "701-256-6156",
"EnumerationDate": "05/06/2021",
"LastUpdateDate": "01/08/2025",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": "M",
"Gender": "Male",
"AuthorizedOfficialLastName": null,
"AuthorizedOfficialFirstName": null,
"AuthorizedOfficialMiddleName": null,
"AuthorizedOfficialTitle": null,
"AuthorizedOfficialNamePrefix": null,
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": null,
"AuthorizedOfficialTelephoneNumber": null,
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "207Q00000X",
"TaxonomyName": "Family Medicine Physician",
"LicenseNumber": "20520",
"LicenseNumberStateCode": "ND",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}