{
"Npi": {
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"EIN": null,
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"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "WOLTER ELSA H",
"LastName": null,
"FirstName": null,
"MiddleName": null,
"NamePrefix": null,
"NameSuffix": null,
"Credential": null,
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"OtherLastName": null,
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"OtherCredential": null,
"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "19390 POWELL RD",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "BROOKSVILLE",
"MailingAddressStateName": "FL",
"MailingAddressPostalCode": "34604-7057",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "352-799-9943",
"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "19390 POWELL RD",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "BROOKSVILLE",
"PracticeLocationAddressStateName": "FL",
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"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "352-799-9943",
"PracticeLocationAddressFaxNumber": null,
"EnumerationDate": "11/01/2015",
"LastUpdateDate": "11/01/2015",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "WOLTER",
"AuthorizedOfficialFirstName": "ELSA",
"AuthorizedOfficialMiddleName": "H",
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"AuthorizedOfficialNamePrefix": null,
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "CNA",
"AuthorizedOfficialTelephoneNumber": "352-799-9943",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "311ZA0620X",
"TaxonomyName": "Adult Care Home Facility",
"LicenseNumber": "6906810",
"LicenseNumberStateCode": "FL",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}