{
"Npi": {
"NPI": "1538533138",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "SCOTT W. TRYLCH",
"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": "579 N WILDERNESS DR",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "MIDLAND",
"MailingAddressStateName": "MI",
"MailingAddressPostalCode": "48640-8628",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "989-631-6990",
"MailingAddressFaxNumber": "989-837-3108",
"FirstLinePracticeLocationAddress": "579 N WILDERNESS DR",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "MIDLAND",
"PracticeLocationAddressStateName": "MI",
"PracticeLocationAddressPostalCode": "48640-8628",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "989-631-6990",
"PracticeLocationAddressFaxNumber": "989-837-3108",
"EnumerationDate": "11/19/2015",
"LastUpdateDate": "11/19/2015",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "TRYLCH",
"AuthorizedOfficialFirstName": "SCOTT",
"AuthorizedOfficialMiddleName": null,
"AuthorizedOfficialTitle": "LICENSED PSYCHOLGIST",
"AuthorizedOfficialNamePrefix": null,
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "EDD",
"AuthorizedOfficialTelephoneNumber": "989-631-6990",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "302R00000X",
"TaxonomyName": "Health Maintenance Organization",
"LicenseNumber": "6301001438",
"LicenseNumberStateCode": "MI",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}