{
"Npi": {
"NPI": "1669738522",
"EntityType": "Individual",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": "N",
"IsOrgSubpart": null,
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": null,
"LastName": "JAMES",
"FirstName": "JOBY",
"MiddleName": "THEKKUMKEL",
"NamePrefix": null,
"NameSuffix": null,
"Credential": "M.D.",
"OtherOrgName": null,
"OtherOrgNameTypeCode": null,
"OtherLastName": "THEKKUMKEL",
"OtherFirstName": "JOBY",
"OtherMiddleName": "JAMES",
"OtherNamePrefix": null,
"OtherNameSuffix": null,
"OtherCredential": "MD",
"OtherLastNameTypeCode": "1",
"FirstLineMailingAddress": "4400 STATE HWY 121",
"SecondLineMailingAddress": "STE 300 #1208",
"MailingAddressCityName": "LEWISVILLE",
"MailingAddressStateName": "TX",
"MailingAddressPostalCode": "75056",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "972-836-8145",
"MailingAddressFaxNumber": "904-621-6965",
"FirstLinePracticeLocationAddress": "4400 STATE HWY 121",
"SecondLinePracticeLocationAddress": "STE 300 #1208",
"PracticeLocationAddressCityName": "LEWISVILLE",
"PracticeLocationAddressStateName": "TX",
"PracticeLocationAddressPostalCode": "75056",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "972-836-8145",
"PracticeLocationAddressFaxNumber": "904-621-6965",
"EnumerationDate": "04/05/2012",
"LastUpdateDate": "07/11/2025",
"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": "207R00000X",
"TaxonomyName": "Internal Medicine Physician",
"LicenseNumber": "29122",
"LicenseNumberStateCode": "OK",
"PrimaryTaxonomySwitch": "N"
},
{
"TaxonomyCode": "207R00000X",
"TaxonomyName": "Internal Medicine Physician",
"LicenseNumber": "R1548",
"LicenseNumberStateCode": "TX",
"PrimaryTaxonomySwitch": "Y"
}
]
},
"HealthcareProviderTaxonomyGroups": null
}
}