{
"Npi": {
"NPI": "1568104529",
"EntityType": "Individual",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": "N",
"IsOrgSubpart": null,
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": null,
"LastName": "PEREZ",
"FirstName": "ERIN",
"MiddleName": "NICOLE",
"NamePrefix": "DR.",
"NameSuffix": null,
"Credential": "MD",
"OtherOrgName": null,
"OtherOrgNameTypeCode": null,
"OtherLastName": null,
"OtherFirstName": null,
"OtherMiddleName": null,
"OtherNamePrefix": null,
"OtherNameSuffix": null,
"OtherCredential": null,
"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "1100 REID PKWY",
"SecondLineMailingAddress": "PAYOR ENROLLMENT",
"MailingAddressCityName": "RICHMOND",
"MailingAddressStateName": "IN",
"MailingAddressPostalCode": "47374-1157",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "765-983-3392",
"MailingAddressFaxNumber": "765-935-8592",
"FirstLinePracticeLocationAddress": "1485 CHESTER BLVD",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "RICHMOND",
"PracticeLocationAddressStateName": "IN",
"PracticeLocationAddressPostalCode": "47374-1919",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "765-966-5527",
"PracticeLocationAddressFaxNumber": "765-966-5528",
"EnumerationDate": "04/11/2022",
"LastUpdateDate": "12/18/2025",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": "F",
"Gender": "Female",
"AuthorizedOfficialLastName": null,
"AuthorizedOfficialFirstName": null,
"AuthorizedOfficialMiddleName": null,
"AuthorizedOfficialTitle": null,
"AuthorizedOfficialNamePrefix": null,
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": null,
"AuthorizedOfficialTelephoneNumber": null,
"Taxonomies": {
"Taxonomy": [
{
"TaxonomyCode": "208000000X",
"TaxonomyName": "Pediatrics Physician",
"LicenseNumber": "01096853A",
"LicenseNumberStateCode": "IN",
"PrimaryTaxonomySwitch": "Y"
},
{
"TaxonomyCode": "390200000X",
"TaxonomyName": "Student in an Organized Health Care Education/Training Program",
"LicenseNumber": null,
"LicenseNumberStateCode": null,
"PrimaryTaxonomySwitch": "N"
}
]
},
"HealthcareProviderTaxonomyGroups": null
}
}