{
"Npi": {
"NPI": "1588858567",
"EntityType": "Individual",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": "Y",
"IsOrgSubpart": null,
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": null,
"LastName": "YIBIRIN PELUFFO",
"FirstName": "EDMUNDO",
"MiddleName": "H",
"NamePrefix": "MR.",
"NameSuffix": null,
"Credential": "M.D",
"OtherOrgName": null,
"OtherOrgNameTypeCode": null,
"OtherLastName": null,
"OtherFirstName": null,
"OtherMiddleName": null,
"OtherNamePrefix": null,
"OtherNameSuffix": null,
"OtherCredential": null,
"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "301 WOLVERINE TRL STE 202",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "SMYRNA",
"MailingAddressStateName": "TN",
"MailingAddressPostalCode": "37167-5656",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "615-801-2087",
"MailingAddressFaxNumber": "615-462-7062",
"FirstLinePracticeLocationAddress": "301 WOLVERINE TRAIL",
"SecondLinePracticeLocationAddress": "SUITE 202",
"PracticeLocationAddressCityName": "SMYRNA",
"PracticeLocationAddressStateName": "TN",
"PracticeLocationAddressPostalCode": "37167",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "615-801-2087",
"PracticeLocationAddressFaxNumber": "615-462-7062",
"EnumerationDate": "08/31/2007",
"LastUpdateDate": "12/13/2024",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": "M",
"Gender": "Male",
"AuthorizedOfficialLastName": null,
"AuthorizedOfficialFirstName": null,
"AuthorizedOfficialMiddleName": null,
"AuthorizedOfficialTitle": null,
"AuthorizedOfficialNamePrefix": null,
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": null,
"AuthorizedOfficialTelephoneNumber": null,
"Taxonomies": {
"Taxonomy": [
{
"TaxonomyCode": "207QA0505X",
"TaxonomyName": "Adult Medicine Physician",
"LicenseNumber": "MD43802",
"LicenseNumberStateCode": "TN",
"PrimaryTaxonomySwitch": "N"
},
{
"TaxonomyCode": "207V00000X",
"TaxonomyName": "Obstetrics & Gynecology Physician",
"LicenseNumber": "MD43802",
"LicenseNumberStateCode": "TN",
"PrimaryTaxonomySwitch": "Y"
}
]
},
"HealthcareProviderTaxonomyGroups": {
"HealthcareProviderTaxonomyGroup": {
"HealthcareProviderTaxonomyGroupName": "193200000X MULTI-SPECIALTY GROUP",
"HealthcareProviderTaxonomyGroupDescription": "Multi-Specialty Group - A business group of one or more individual practitioners, who practice with different areas of specialization."
}
}
}
}