{
"Npi": {
"NPI": "1649710328",
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"EIN": null,
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"IsOrgSubpart": "N",
"ParentOrgLBN": null,
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"OrgName": "CITY OF SURPRISE",
"LastName": null,
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"MiddleName": null,
"NamePrefix": null,
"NameSuffix": null,
"Credential": null,
"OtherOrgName": null,
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"FirstLineMailingAddress": "DEPT #880156 PO BOX 29650",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "PHOENIX",
"MailingAddressStateName": "AZ",
"MailingAddressPostalCode": "85038-9650",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "623-222-1000",
"MailingAddressFaxNumber": "623-222-5001",
"FirstLinePracticeLocationAddress": "14250 W STATLER PLZ STE 101",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "SURPRISE",
"PracticeLocationAddressStateName": "AZ",
"PracticeLocationAddressPostalCode": "85374-7474",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "623-222-5000",
"PracticeLocationAddressFaxNumber": null,
"EnumerationDate": "03/01/2017",
"LastUpdateDate": "03/15/2021",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "ABBOTT",
"AuthorizedOfficialFirstName": "TOM",
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"AuthorizedOfficialTitle": "DIRECTOR",
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"AuthorizedOfficialCredential": null,
"AuthorizedOfficialTelephoneNumber": "623-222-5000",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "261QC1500X",
"TaxonomyName": "Community Health Clinic/Center",
"LicenseNumber": "TRN: 17-002",
"LicenseNumberStateCode": "AZ",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}