{
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"IsOrgSubpart": "N",
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"OrgName": "CITY OF DES PERES",
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"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "12325 MANCHESTER RD",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "SAINT LOUIS",
"MailingAddressStateName": "MO",
"MailingAddressPostalCode": "63131-4316",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "314-835-6113",
"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "1000 N BALLAS RD",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "DES PERES",
"PracticeLocationAddressStateName": "MO",
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"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "314-822-1500",
"PracticeLocationAddressFaxNumber": null,
"EnumerationDate": "03/16/2006",
"LastUpdateDate": "02/14/2023",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "FIALA",
"AuthorizedOfficialFirstName": "DALE",
"AuthorizedOfficialMiddleName": null,
"AuthorizedOfficialTitle": "ASSISTANT FIRE CHIEF",
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"AuthorizedOfficialCredential": null,
"AuthorizedOfficialTelephoneNumber": "314-835-6231",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "3416L0300X",
"TaxonomyName": "Land Ambulance",
"LicenseNumber": "189201",
"LicenseNumberStateCode": "MO",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}