{
"Npi": {
"NPI": "1558472654",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "QUICKCLINIC",
"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": "94 FOX TRACE LN",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "HUDSON",
"MailingAddressStateName": "OH",
"MailingAddressPostalCode": "44236-3469",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "330-656-0956",
"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "4445 KENT RD",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "STOW",
"PracticeLocationAddressStateName": "OH",
"PracticeLocationAddressPostalCode": "44224-4332",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "330-678-3500",
"PracticeLocationAddressFaxNumber": null,
"EnumerationDate": "08/31/2006",
"LastUpdateDate": "08/22/2020",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "BUCCI",
"AuthorizedOfficialFirstName": "RONALD",
"AuthorizedOfficialMiddleName": null,
"AuthorizedOfficialTitle": "PRESIDENT AND CEO",
"AuthorizedOfficialNamePrefix": "MR.",
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "PHD",
"AuthorizedOfficialTelephoneNumber": "330-665-0010",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "261Q00000X",
"TaxonomyName": "Clinic/Center",
"LicenseNumber": "RN251833",
"LicenseNumberStateCode": "OH",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}