{
"Npi": {
"NPI": "1538815568",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "ICARE365 HEALTH AND WELLNESS CLINIC LLC",
"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": "2111 EAST CROSSROADS LANE,",
"SecondLineMailingAddress": "#200",
"MailingAddressCityName": "OLATHE",
"MailingAddressStateName": "KS",
"MailingAddressPostalCode": "66062",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "913-850-3430",
"MailingAddressFaxNumber": "949-437-3459",
"FirstLinePracticeLocationAddress": "2111 E CROSSROADS LN STE 200",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "OLATHE",
"PracticeLocationAddressStateName": "KS",
"PracticeLocationAddressPostalCode": "66062-1658",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "785-727-0232",
"PracticeLocationAddressFaxNumber": "949-437-3459",
"EnumerationDate": "02/28/2022",
"LastUpdateDate": "06/09/2022",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "NGIGI",
"AuthorizedOfficialFirstName": "PATRICIA",
"AuthorizedOfficialMiddleName": null,
"AuthorizedOfficialTitle": "DNP, APRN, FNP-C",
"AuthorizedOfficialNamePrefix": "DR.",
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "NURSE PRACTITIONER",
"AuthorizedOfficialTelephoneNumber": "913-850-3430",
"Taxonomies": {
"Taxonomy": [
{
"TaxonomyCode": "363LF0000X",
"TaxonomyName": "Family Nurse Practitioner",
"LicenseNumber": null,
"LicenseNumberStateCode": null,
"PrimaryTaxonomySwitch": "N"
},
{
"TaxonomyCode": "261QP2300X",
"TaxonomyName": "Primary Care Clinic/Center",
"LicenseNumber": null,
"LicenseNumberStateCode": null,
"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."
}
}
}
}