{
"Npi": {
"NPI": "1548599483",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "WILDCAT TOWNSHIP TRUSTEE",
"LastName": null,
"FirstName": null,
"MiddleName": null,
"NamePrefix": null,
"NameSuffix": null,
"Credential": null,
"OtherOrgName": null,
"OtherOrgNameTypeCode": "6",
"OtherLastName": null,
"OtherFirstName": null,
"OtherMiddleName": null,
"OtherNamePrefix": null,
"OtherNameSuffix": null,
"OtherCredential": null,
"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "208 S. INDEPENDENCE ST.",
"SecondLineMailingAddress": "BOX 253",
"MailingAddressCityName": "WINDFALL",
"MailingAddressStateName": "IN",
"MailingAddressPostalCode": "46076",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "765-945-7301",
"MailingAddressFaxNumber": "765-945-7863",
"FirstLinePracticeLocationAddress": "208 S. INDEPENDENCE ST.",
"SecondLinePracticeLocationAddress": "BOX 253",
"PracticeLocationAddressCityName": "WINDFALL",
"PracticeLocationAddressStateName": "IN",
"PracticeLocationAddressPostalCode": "46076",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "765-945-7301",
"PracticeLocationAddressFaxNumber": "765-945-7863",
"EnumerationDate": "12/23/2009",
"LastUpdateDate": "12/23/2009",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "HORNER",
"AuthorizedOfficialFirstName": "BILL",
"AuthorizedOfficialMiddleName": null,
"AuthorizedOfficialTitle": "CHIEF MEDICAL",
"AuthorizedOfficialNamePrefix": null,
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "EMT-B",
"AuthorizedOfficialTelephoneNumber": "765-945-7301",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "343900000X",
"TaxonomyName": "Non-emergency Medical Transport (VAN)",
"LicenseNumber": "0573",
"LicenseNumberStateCode": "IN",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}