{
"Npi": {
"NPI": "1720864143",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "Y",
"ParentOrgLBN": "APPALACHIAN STATE UNIVERSITY",
"ParentOrgTIN": null,
"OrgName": "APPALACHIAN STATE UNIVERSITY",
"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": "ASU BOX 32112",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "BOONE",
"MailingAddressStateName": "NC",
"MailingAddressPostalCode": "28608-2112",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": null,
"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "175 LOCUST ST",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "BOONE",
"PracticeLocationAddressStateName": "NC",
"PracticeLocationAddressPostalCode": "28608-0007",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "828-262-4008",
"PracticeLocationAddressFaxNumber": null,
"EnumerationDate": "09/01/2023",
"LastUpdateDate": "09/01/2023",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "MARSHBURN",
"AuthorizedOfficialFirstName": "JASON",
"AuthorizedOfficialMiddleName": null,
"AuthorizedOfficialTitle": "DIRECTOR OF SAFETY & EMERGENCY MGT",
"AuthorizedOfficialNamePrefix": "MR.",
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": null,
"AuthorizedOfficialTelephoneNumber": "828-262-8081",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "261QE0002X",
"TaxonomyName": "Emergency Care Clinic/Center",
"LicenseNumber": null,
"LicenseNumberStateCode": null,
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}