{
"Npi": {
"NPI": "1740615426",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "A PLUS MINOR EMERGENCY WALK IN 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": "916 N MAIN",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "ALTUS",
"MailingAddressStateName": "OK",
"MailingAddressPostalCode": "73521-3118",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "580-480-0033",
"MailingAddressFaxNumber": "580-480-0044",
"FirstLinePracticeLocationAddress": "916 N MAIN ST",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "ALTUS",
"PracticeLocationAddressStateName": "OK",
"PracticeLocationAddressPostalCode": "73521-3118",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "580-480-0033",
"PracticeLocationAddressFaxNumber": "580-480-0044",
"EnumerationDate": "09/12/2013",
"LastUpdateDate": "12/26/2014",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "NEAL",
"AuthorizedOfficialFirstName": "ANTHONY",
"AuthorizedOfficialMiddleName": "QUINN",
"AuthorizedOfficialTitle": "OWNER/MANAGER",
"AuthorizedOfficialNamePrefix": "DR.",
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": null,
"AuthorizedOfficialTelephoneNumber": "580-318-0307",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "261QU0200X",
"TaxonomyName": "Urgent Care Clinic/Center",
"LicenseNumber": "OK3838",
"LicenseNumberStateCode": "OK",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}