{
"Npi": {
"NPI": "1548422462",
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"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "AMBULATORY CARE CLINIC OF IONIA PC",
"LastName": null,
"FirstName": null,
"MiddleName": null,
"NamePrefix": null,
"NameSuffix": null,
"Credential": null,
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"OtherLastName": null,
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"OtherCredential": null,
"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "3015 S STATE RD",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "IONIA",
"MailingAddressStateName": "MI",
"MailingAddressPostalCode": "48846-9416",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "616-522-9110",
"MailingAddressFaxNumber": "616-522-9114",
"FirstLinePracticeLocationAddress": "3015 S STATE RD",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "IONIA",
"PracticeLocationAddressStateName": "MI",
"PracticeLocationAddressPostalCode": "48846-9416",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "616-522-9110",
"PracticeLocationAddressFaxNumber": "616-522-9114",
"EnumerationDate": "07/01/2008",
"LastUpdateDate": "07/01/2008",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "SMITH",
"AuthorizedOfficialFirstName": "TERESA",
"AuthorizedOfficialMiddleName": null,
"AuthorizedOfficialTitle": "OFFICE MANAGER",
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"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": null,
"AuthorizedOfficialTelephoneNumber": "616-522-9110",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "261QP2300X",
"TaxonomyName": "Primary Care Clinic/Center",
"LicenseNumber": "4301063290",
"LicenseNumberStateCode": "MI",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}