{
"Npi": {
"NPI": "1699759001",
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"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
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"OrgName": "ELLEN STEPHEN HOSPICE AND HOMECARE",
"LastName": null,
"FirstName": null,
"MiddleName": null,
"NamePrefix": null,
"NameSuffix": null,
"Credential": null,
"OtherOrgName": null,
"OtherOrgNameTypeCode": null,
"OtherLastName": null,
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"OtherNamePrefix": null,
"OtherNameSuffix": null,
"OtherCredential": null,
"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "PO BOX 488",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "KYLE",
"MailingAddressStateName": "SD",
"MailingAddressPostalCode": "57752-0488",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "605-455-1217",
"MailingAddressFaxNumber": "605-455-1218",
"FirstLinePracticeLocationAddress": "1 MAIN",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "KYLE",
"PracticeLocationAddressStateName": "SD",
"PracticeLocationAddressPostalCode": "57752",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "605-455-1217",
"PracticeLocationAddressFaxNumber": "605-455-1218",
"EnumerationDate": "11/30/2005",
"LastUpdateDate": "07/21/2022",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "WILLIAMS",
"AuthorizedOfficialFirstName": "BRUCE",
"AuthorizedOfficialMiddleName": "ALAN",
"AuthorizedOfficialTitle": "DIRECTOR/RN",
"AuthorizedOfficialNamePrefix": "MR.",
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "RN",
"AuthorizedOfficialTelephoneNumber": "605-455-1217",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "163WH0200X",
"TaxonomyName": "Home Health Registered Nurse",
"LicenseNumber": null,
"LicenseNumberStateCode": "SD",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": {
"HealthcareProviderTaxonomyGroup": {
"HealthcareProviderTaxonomyGroupName": "193400000X SINGLE SPECIALTY GROUP",
"HealthcareProviderTaxonomyGroupDescription": "Single Specialty Group - A business group of one or more individual practitioners, all of who practice with the same area of specialization."
}
}
}
}