{
"Npi": {
"NPI": "1790842284",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "EVERCARE",
"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": "34 CODY AVE",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "BALTIMORE",
"MailingAddressStateName": "MD",
"MailingAddressPostalCode": "21234-1376",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "410-529-2960",
"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "6085 MARSHALEE DR",
"SecondLinePracticeLocationAddress": "SUITE 110",
"PracticeLocationAddressCityName": "ELKRIDGE",
"PracticeLocationAddressStateName": "MD",
"PracticeLocationAddressPostalCode": "21075-6023",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "443-691-2440",
"PracticeLocationAddressFaxNumber": null,
"EnumerationDate": "01/03/2007",
"LastUpdateDate": "06/18/2008",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "DUFFEY",
"AuthorizedOfficialFirstName": "KRISTY",
"AuthorizedOfficialMiddleName": null,
"AuthorizedOfficialTitle": "DIRECTIOR OF CLINICAL SERVICES",
"AuthorizedOfficialNamePrefix": "MRS.",
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "CRNP",
"AuthorizedOfficialTelephoneNumber": "443-506-4361",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "313M00000X",
"TaxonomyName": "Nursing Facility/Intermediate Care Facility",
"LicenseNumber": "R127624",
"LicenseNumberStateCode": "MD",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}