{
"Npi": {
"NPI": "1750570636",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "JACOB M. RYBCZYNSKI DPM PC",
"LastName": null,
"FirstName": null,
"MiddleName": null,
"NamePrefix": null,
"NameSuffix": null,
"Credential": null,
"OtherOrgName": null,
"OtherOrgNameTypeCode": "6",
"OtherLastName": null,
"OtherFirstName": null,
"OtherMiddleName": null,
"OtherNamePrefix": null,
"OtherNameSuffix": null,
"OtherCredential": null,
"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "13724 FORT ST",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "SOUTHGATE",
"MailingAddressStateName": "MI",
"MailingAddressPostalCode": "48195-1153",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "734-282-1636",
"MailingAddressFaxNumber": "734-282-2967",
"FirstLinePracticeLocationAddress": "13724 FORT ST",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "SOUTHGATE",
"PracticeLocationAddressStateName": "MI",
"PracticeLocationAddressPostalCode": "48195-1153",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "734-282-1636",
"PracticeLocationAddressFaxNumber": "734-282-2967",
"EnumerationDate": "10/17/2007",
"LastUpdateDate": "06/17/2008",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "RYBCZYNSKI",
"AuthorizedOfficialFirstName": "JACOB",
"AuthorizedOfficialMiddleName": "MICHEAL",
"AuthorizedOfficialTitle": "PHYSICAN",
"AuthorizedOfficialNamePrefix": "DR.",
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "D.P.M.",
"AuthorizedOfficialTelephoneNumber": "734-282-1636",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "332B00000X",
"TaxonomyName": "Durable Medical Equipment & Medical Supplies",
"LicenseNumber": "JR000727",
"LicenseNumberStateCode": "MI",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}