{
"Npi": {
"NPI": "1801243688",
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"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "APEX HEALTHCARE GROUP PC",
"LastName": null,
"FirstName": null,
"MiddleName": null,
"NamePrefix": null,
"NameSuffix": null,
"Credential": null,
"OtherOrgName": null,
"OtherOrgNameTypeCode": null,
"OtherLastName": null,
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"OtherMiddleName": null,
"OtherNamePrefix": null,
"OtherNameSuffix": null,
"OtherCredential": null,
"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "3665 PARK PL W",
"SecondLineMailingAddress": "SUITE #300",
"MailingAddressCityName": "MISHAWAKA",
"MailingAddressStateName": "IN",
"MailingAddressPostalCode": "46545-3566",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "574-314-6436",
"MailingAddressFaxNumber": "574-485-2984",
"FirstLinePracticeLocationAddress": "3665 PARK PL W",
"SecondLinePracticeLocationAddress": "SUITE #300",
"PracticeLocationAddressCityName": "MISHAWAKA",
"PracticeLocationAddressStateName": "IN",
"PracticeLocationAddressPostalCode": "46545-3566",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "574-314-6436",
"PracticeLocationAddressFaxNumber": "574-485-2984",
"EnumerationDate": "05/20/2016",
"LastUpdateDate": "08/26/2016",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "TUTTLE",
"AuthorizedOfficialFirstName": "JACOB",
"AuthorizedOfficialMiddleName": "LAWRENCE",
"AuthorizedOfficialTitle": "PRESIDENT",
"AuthorizedOfficialNamePrefix": "DR.",
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "M.D.",
"AuthorizedOfficialTelephoneNumber": "574-314-6436",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "261QP2300X",
"TaxonomyName": "Primary Care Clinic/Center",
"LicenseNumber": "01072927A",
"LicenseNumberStateCode": "IN",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}