{
"Npi": {
"NPI": "1760172068",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "ESR MEDICAL TRANSPORTATION LLC",
"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": "1868 NIAGARA FALLS BLVD",
"SecondLineMailingAddress": "SUITE 208",
"MailingAddressCityName": "TONAWANDA",
"MailingAddressStateName": "NY",
"MailingAddressPostalCode": "14150",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "716-389-0080",
"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "1868 NIAGARA FALLS BLVD",
"SecondLinePracticeLocationAddress": "SUITE 208",
"PracticeLocationAddressCityName": "TONAWANDA",
"PracticeLocationAddressStateName": "NY",
"PracticeLocationAddressPostalCode": "14150",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "716-389-0080",
"PracticeLocationAddressFaxNumber": null,
"EnumerationDate": "05/10/2023",
"LastUpdateDate": "05/10/2023",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "BRANTLEY",
"AuthorizedOfficialFirstName": "RONALD",
"AuthorizedOfficialMiddleName": null,
"AuthorizedOfficialTitle": "OWNER",
"AuthorizedOfficialNamePrefix": null,
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": null,
"AuthorizedOfficialTelephoneNumber": "716-818-8899",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "343900000X",
"TaxonomyName": "Non-emergency Medical Transport (VAN)",
"LicenseNumber": null,
"LicenseNumberStateCode": null,
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}