{
"Npi": {
"NPI": "1760486187",
"EntityType": "Individual",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": "N",
"IsOrgSubpart": null,
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": null,
"LastName": "WOLFE",
"FirstName": "HEATHER",
"MiddleName": "J.",
"NamePrefix": null,
"NameSuffix": null,
"Credential": "MD",
"OtherOrgName": null,
"OtherOrgNameTypeCode": null,
"OtherLastName": null,
"OtherFirstName": null,
"OtherMiddleName": null,
"OtherNamePrefix": null,
"OtherNameSuffix": null,
"OtherCredential": null,
"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "6920 POINTE INVERNESS WAY STE 200",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "FORT WAYNE",
"MailingAddressStateName": "IN",
"MailingAddressPostalCode": "46804-7934",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "260-435-2852",
"MailingAddressFaxNumber": "260-435-6695",
"FirstLinePracticeLocationAddress": "7950 W JEFFERSON BLVD STE 210",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "FORT WAYNE",
"PracticeLocationAddressStateName": "IN",
"PracticeLocationAddressPostalCode": "46804-4140",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "260-435-2852",
"PracticeLocationAddressFaxNumber": "260-435-6695",
"EnumerationDate": "06/13/2005",
"LastUpdateDate": "07/14/2021",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": "F",
"Gender": "Female",
"AuthorizedOfficialLastName": null,
"AuthorizedOfficialFirstName": null,
"AuthorizedOfficialMiddleName": null,
"AuthorizedOfficialTitle": null,
"AuthorizedOfficialNamePrefix": null,
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": null,
"AuthorizedOfficialTelephoneNumber": null,
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "208000000X",
"TaxonomyName": "Pediatrics Physician",
"LicenseNumber": "01056650A",
"LicenseNumberStateCode": "IN",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}