{
"Npi": {
"NPI": "1619037462",
"EntityType": "Individual",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": "Y",
"IsOrgSubpart": null,
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": null,
"LastName": "VOGEL",
"FirstName": "MARIT",
"MiddleName": "ELIZABETH",
"NamePrefix": "DR.",
"NameSuffix": null,
"Credential": "M.D.",
"OtherOrgName": null,
"OtherOrgNameTypeCode": null,
"OtherLastName": "COLFER",
"OtherFirstName": "MARIT",
"OtherMiddleName": "VOGEL",
"OtherNamePrefix": "DR.",
"OtherNameSuffix": null,
"OtherCredential": "M.D.",
"OtherLastNameTypeCode": "1",
"FirstLineMailingAddress": "3260 WOODS WAY",
"SecondLineMailingAddress": "SUITE ONE",
"MailingAddressCityName": "PETOSKEY",
"MailingAddressStateName": "MI",
"MailingAddressPostalCode": "49770-8694",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "231-348-5590",
"MailingAddressFaxNumber": "231-348-5676",
"FirstLinePracticeLocationAddress": "3260 WOODS WAY",
"SecondLinePracticeLocationAddress": "SUITE ONE",
"PracticeLocationAddressCityName": "PETOSKEY",
"PracticeLocationAddressStateName": "MI",
"PracticeLocationAddressPostalCode": "49770-8694",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "231-348-5590",
"PracticeLocationAddressFaxNumber": "231-348-5676",
"EnumerationDate": "12/11/2006",
"LastUpdateDate": "07/08/2007",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": "F",
"Gender": "Female",
"AuthorizedOfficialLastName": null,
"AuthorizedOfficialFirstName": null,
"AuthorizedOfficialMiddleName": null,
"AuthorizedOfficialTitle": null,
"AuthorizedOfficialNamePrefix": null,
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": null,
"AuthorizedOfficialTelephoneNumber": null,
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "2084P0804X",
"TaxonomyName": "Child & Adolescent Psychiatry Physician",
"LicenseNumber": "4301038132",
"LicenseNumberStateCode": "MI",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}