{
"Npi": {
"NPI": "1831611375",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "D & D PRIMARY 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": "844 N JOHN YOUNG PKWY # A",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "KISSIMMEE",
"MailingAddressStateName": "FL",
"MailingAddressPostalCode": "34741-4912",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "407-795-7705",
"MailingAddressFaxNumber": "407-956-8820",
"FirstLinePracticeLocationAddress": "844 N JOHN YOUNG PKWY",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "KISSIMMEE",
"PracticeLocationAddressStateName": "FL",
"PracticeLocationAddressPostalCode": "34741-4912",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "407-795-7705",
"PracticeLocationAddressFaxNumber": null,
"EnumerationDate": "07/15/2017",
"LastUpdateDate": "03/07/2025",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "GORDON",
"AuthorizedOfficialFirstName": "DARLENE",
"AuthorizedOfficialMiddleName": null,
"AuthorizedOfficialTitle": "OWNER/CEO/AAPRN/FNP-BC",
"AuthorizedOfficialNamePrefix": "DR.",
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": null,
"AuthorizedOfficialTelephoneNumber": "407-795-7705",
"Taxonomies": {
"Taxonomy": [
{
"TaxonomyCode": "253Z00000X",
"TaxonomyName": "In Home Supportive Care Agency",
"LicenseNumber": null,
"LicenseNumberStateCode": null,
"PrimaryTaxonomySwitch": "N"
},
{
"TaxonomyCode": "320900000X",
"TaxonomyName": "Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility",
"LicenseNumber": null,
"LicenseNumberStateCode": null,
"PrimaryTaxonomySwitch": "N"
},
{
"TaxonomyCode": "385H00000X",
"TaxonomyName": "Respite Care",
"LicenseNumber": null,
"LicenseNumberStateCode": null,
"PrimaryTaxonomySwitch": "N"
},
{
"TaxonomyCode": "363LC1500X",
"TaxonomyName": "Community Health Nurse Practitioner",
"LicenseNumber": null,
"LicenseNumberStateCode": null,
"PrimaryTaxonomySwitch": "Y"
}
]
},
"HealthcareProviderTaxonomyGroups": {
"HealthcareProviderTaxonomyGroup": {
"HealthcareProviderTaxonomyGroupName": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
"HealthcareProviderTaxonomyGroupDescription": "Single Specialty Group - A business group of one or more individual practitioners, all of who practice with the same area of specialization."
}
}
}
}