{
"Npi": {
"NPI": "1598946568",
"EntityType": "Individual",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": "N",
"IsOrgSubpart": null,
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": null,
"LastName": "CHITU",
"FirstName": "IOAN",
"MiddleName": "JOHN",
"NamePrefix": null,
"NameSuffix": "I",
"Credential": null,
"OtherOrgName": null,
"OtherOrgNameTypeCode": null,
"OtherLastName": "CHITU",
"OtherFirstName": "JOHN",
"OtherMiddleName": null,
"OtherNamePrefix": null,
"OtherNameSuffix": null,
"OtherCredential": "PA",
"OtherLastNameTypeCode": "5",
"FirstLineMailingAddress": "323 S MINNESOTA ST",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "CROOKSTON",
"MailingAddressStateName": "MN",
"MailingAddressPostalCode": "56716-1601",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "218-281-9553",
"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "323 S MINNESOTA ST",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "CROOKSTON",
"PracticeLocationAddressStateName": "MN",
"PracticeLocationAddressPostalCode": "56716-1601",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "218-281-9553",
"PracticeLocationAddressFaxNumber": null,
"EnumerationDate": "11/19/2007",
"LastUpdateDate": "05/22/2008",
"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": "363AM0700X",
"TaxonomyName": "Medical Physician Assistant",
"LicenseNumber": "10322",
"LicenseNumberStateCode": "MN",
"PrimaryTaxonomySwitch": "Y"
},
{
"TaxonomyCode": "363AS0400X",
"TaxonomyName": "Surgical Physician Assistant",
"LicenseNumber": "10322",
"LicenseNumberStateCode": "MN",
"PrimaryTaxonomySwitch": "N"
}
]
},
"HealthcareProviderTaxonomyGroups": null
}
}