{
"Npi": {
"NPI": "1609937572",
"EntityType": "Individual",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": "Y",
"IsOrgSubpart": null,
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": null,
"LastName": "ROONEY",
"FirstName": "JOHN",
"MiddleName": "EDWARD",
"NamePrefix": "MR.",
"NameSuffix": null,
"Credential": "C.P., CPED., L.O.",
"OtherOrgName": null,
"OtherOrgNameTypeCode": null,
"OtherLastName": null,
"OtherFirstName": null,
"OtherMiddleName": null,
"OtherNamePrefix": null,
"OtherNameSuffix": null,
"OtherCredential": null,
"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "121 E ROOSEVELT RD",
"SecondLineMailingAddress": "SUITE B & C",
"MailingAddressCityName": "LOMBARD",
"MailingAddressStateName": "IL",
"MailingAddressPostalCode": "60148-4561",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "630-261-9317",
"MailingAddressFaxNumber": "630-261-9319",
"FirstLinePracticeLocationAddress": "121 E ROOSEVELT RD",
"SecondLinePracticeLocationAddress": "SUITE B & C",
"PracticeLocationAddressCityName": "LOMBARD",
"PracticeLocationAddressStateName": "IL",
"PracticeLocationAddressPostalCode": "60148-4561",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "630-261-9317",
"PracticeLocationAddressFaxNumber": "630-261-9319",
"EnumerationDate": "12/13/2006",
"LastUpdateDate": "01/16/2008",
"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": "335E00000X",
"TaxonomyName": "Prosthetic/Orthotic Supplier",
"LicenseNumber": null,
"LicenseNumberStateCode": "IL",
"PrimaryTaxonomySwitch": "N"
},
{
"TaxonomyCode": "335E00000X",
"TaxonomyName": "Prosthetic/Orthotic Supplier",
"LicenseNumber": null,
"LicenseNumberStateCode": "IL",
"PrimaryTaxonomySwitch": "Y"
},
{
"TaxonomyCode": "335E00000X",
"TaxonomyName": "Prosthetic/Orthotic Supplier",
"LicenseNumber": null,
"LicenseNumberStateCode": "IL",
"PrimaryTaxonomySwitch": "N"
}
]
},
"HealthcareProviderTaxonomyGroups": null
}
}