{
"Npi": {
"NPI": "1710170089",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "SAINT FRANCIS MEDICAL CLINIC",
"LastName": null,
"FirstName": null,
"MiddleName": null,
"NamePrefix": null,
"NameSuffix": null,
"Credential": null,
"OtherOrgName": null,
"OtherOrgNameTypeCode": null,
"OtherLastName": null,
"OtherFirstName": null,
"OtherMiddleName": null,
"OtherNamePrefix": null,
"OtherNameSuffix": null,
"OtherCredential": null,
"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "23671 SAINT FRANCIS BLVD NW",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "SAINT FRANCIS",
"MailingAddressStateName": "MN",
"MailingAddressPostalCode": "55070-9802",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "763-753-8724",
"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "23671 SAINT FRANCIS BLVD NW",
"SecondLinePracticeLocationAddress": "SUITE 104",
"PracticeLocationAddressCityName": "SAINT FRANCIS",
"PracticeLocationAddressStateName": "MN",
"PracticeLocationAddressPostalCode": "55070-9802",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "763-753-8724",
"PracticeLocationAddressFaxNumber": null,
"EnumerationDate": "08/21/2007",
"LastUpdateDate": "02/13/2009",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "SHOEMAKER",
"AuthorizedOfficialFirstName": "MARK",
"AuthorizedOfficialMiddleName": "ALDEN",
"AuthorizedOfficialTitle": "OWNER",
"AuthorizedOfficialNamePrefix": "MR.",
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "PA-C",
"AuthorizedOfficialTelephoneNumber": "763-753-8724",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "261Q00000X",
"TaxonomyName": "Clinic/Center",
"LicenseNumber": "MN8822",
"LicenseNumberStateCode": "MN",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}