{
"Npi": {
"NPI": "1568654002",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "MED SERVICE WALK-IN CLINIC P C",
"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": "201 WESTSHORE DR",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "JEROME",
"MailingAddressStateName": "MI",
"MailingAddressPostalCode": "49249-9420",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "517-529-9266",
"MailingAddressFaxNumber": "517-529-9277",
"FirstLinePracticeLocationAddress": "34336 HARPER AVE",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "CLINTON TWP",
"PracticeLocationAddressStateName": "MI",
"PracticeLocationAddressPostalCode": "48035-3704",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "586-791-9173",
"PracticeLocationAddressFaxNumber": "586-791-9373",
"EnumerationDate": "08/17/2007",
"LastUpdateDate": "01/21/2016",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "ASKINS",
"AuthorizedOfficialFirstName": "JAMES",
"AuthorizedOfficialMiddleName": "C",
"AuthorizedOfficialTitle": "OWNER/MEDICAL DIRECTOR",
"AuthorizedOfficialNamePrefix": "DR.",
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "M.D.",
"AuthorizedOfficialTelephoneNumber": "586-791-9173",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "208D00000X",
"TaxonomyName": "General Practice Physician",
"LicenseNumber": "JA029205",
"LicenseNumberStateCode": "MI",
"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."
}
}
}
}