{
"Npi": {
"NPI": "1760951644",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "PROSPECT URGENT CARE LLC",
"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": "PO BOX 933269",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "CLEVELAND",
"MailingAddressStateName": "OH",
"MailingAddressPostalCode": "44193-0035",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "248-957-7999",
"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "417 W PROSPECT RD",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "ASHTABULA",
"PracticeLocationAddressStateName": "OH",
"PracticeLocationAddressPostalCode": "44004-5862",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "248-957-7999",
"PracticeLocationAddressFaxNumber": null,
"EnumerationDate": "11/20/2018",
"LastUpdateDate": "10/17/2023",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "IFTIKHAR",
"AuthorizedOfficialFirstName": "FARAH",
"AuthorizedOfficialMiddleName": null,
"AuthorizedOfficialTitle": "OWNER",
"AuthorizedOfficialNamePrefix": null,
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "MD",
"AuthorizedOfficialTelephoneNumber": "248-957-7999",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "261QU0200X",
"TaxonomyName": "Urgent Care Clinic/Center",
"LicenseNumber": null,
"LicenseNumberStateCode": null,
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}