{
"Npi": {
"NPI": "1598916264",
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"EIN": null,
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"IsOrgSubpart": "N",
"ParentOrgLBN": null,
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"OrgName": "FIRST MEDICAL PLUS FAMILY PRACTICE INC",
"LastName": null,
"FirstName": null,
"MiddleName": null,
"NamePrefix": null,
"NameSuffix": null,
"Credential": null,
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"FirstLineMailingAddress": "4222 N 12TH ST",
"SecondLineMailingAddress": "SUITE 102",
"MailingAddressCityName": "PHOENIX",
"MailingAddressStateName": "AZ",
"MailingAddressPostalCode": "85014-6008",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "602-265-4357",
"MailingAddressFaxNumber": "602-604-9352",
"FirstLinePracticeLocationAddress": "2724 W THOMAS RD",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "PHOENIX",
"PracticeLocationAddressStateName": "AZ",
"PracticeLocationAddressPostalCode": "85017-5514",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "602-353-1166",
"PracticeLocationAddressFaxNumber": "602-353-1188",
"EnumerationDate": "09/30/2008",
"LastUpdateDate": "11/20/2008",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "SICAIROS",
"AuthorizedOfficialFirstName": "MARIA",
"AuthorizedOfficialMiddleName": "PATRICIA",
"AuthorizedOfficialTitle": "HUMAN RESOURCE",
"AuthorizedOfficialNamePrefix": "MRS.",
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": null,
"AuthorizedOfficialTelephoneNumber": "602-265-4357",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "207Q00000X",
"TaxonomyName": "Family Medicine Physician",
"LicenseNumber": "3858",
"LicenseNumberStateCode": "AZ",
"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."
}
}
}
}