{
"Npi": {
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"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "SOUTHERN INDIANA FAMILY PRACTICE CENTER PC",
"LastName": null,
"FirstName": null,
"MiddleName": null,
"NamePrefix": null,
"NameSuffix": null,
"Credential": null,
"OtherOrgName": null,
"OtherOrgNameTypeCode": "6",
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"OtherCredential": null,
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"FirstLineMailingAddress": "3209 W FULLERTON PIKE",
"SecondLineMailingAddress": "STE A",
"MailingAddressCityName": "BLOOMINGTON",
"MailingAddressStateName": "IN",
"MailingAddressPostalCode": "47403-4060",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "812-339-6744",
"MailingAddressFaxNumber": "812-671-9113",
"FirstLinePracticeLocationAddress": "3209 W FULLERTON PIKE",
"SecondLinePracticeLocationAddress": "STE A",
"PracticeLocationAddressCityName": "BLOOMINGTON",
"PracticeLocationAddressStateName": "IN",
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"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "812-339-6744",
"PracticeLocationAddressFaxNumber": "812-671-9113",
"EnumerationDate": "02/15/2007",
"LastUpdateDate": "11/20/2015",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "REID-RENNER",
"AuthorizedOfficialFirstName": "KAREN",
"AuthorizedOfficialMiddleName": "L.",
"AuthorizedOfficialTitle": "OWNER",
"AuthorizedOfficialNamePrefix": null,
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "MD",
"AuthorizedOfficialTelephoneNumber": "812-339-6744",
"Taxonomies": {
"Taxonomy": [
{
"TaxonomyCode": "363L00000X",
"TaxonomyName": "Nurse Practitioner",
"LicenseNumber": "71002130A",
"LicenseNumberStateCode": "IN",
"PrimaryTaxonomySwitch": "N"
},
{
"TaxonomyCode": "305R00000X",
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"PrimaryTaxonomySwitch": "Y"
}
]
},
"HealthcareProviderTaxonomyGroups": {
"HealthcareProviderTaxonomyGroup": {
"HealthcareProviderTaxonomyGroupName": "193200000X MULTI-SPECIALTY GROUP",
"HealthcareProviderTaxonomyGroupDescription": "Multi-Specialty Group - A business group of one or more individual practitioners, who practice with different areas of specialization."
}
}
}
}