{
"Npi": {
"NPI": "1801113147",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "PEAK HEALTHCARE, INC",
"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": "894 E 100 N",
"SecondLineMailingAddress": "SUITE 3",
"MailingAddressCityName": "PRICE",
"MailingAddressStateName": "UT",
"MailingAddressPostalCode": "84501-2711",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "435-637-2324",
"MailingAddressFaxNumber": "435-637-2326",
"FirstLinePracticeLocationAddress": "894 E 100 N",
"SecondLinePracticeLocationAddress": "SUITE 3",
"PracticeLocationAddressCityName": "PRICE",
"PracticeLocationAddressStateName": "UT",
"PracticeLocationAddressPostalCode": "84501-2711",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "435-637-2324",
"PracticeLocationAddressFaxNumber": "435-637-2326",
"EnumerationDate": "04/27/2010",
"LastUpdateDate": "04/27/2010",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "CALLAHAN",
"AuthorizedOfficialFirstName": "TIMOTHY",
"AuthorizedOfficialMiddleName": "ADAM",
"AuthorizedOfficialTitle": "PHYSICIAN ASSISTANT/OWNER",
"AuthorizedOfficialNamePrefix": "MR.",
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "P.A.-C",
"AuthorizedOfficialTelephoneNumber": "435-637-2324",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "261QP2300X",
"TaxonomyName": "Primary Care Clinic/Center",
"LicenseNumber": "363AM0700X",
"LicenseNumberStateCode": "UT",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}