{
"Npi": {
"NPI": "1891012811",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "JEFFREY TUTTLE, M.D., P.L.L.C.",
"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": "219 E HIGH ST",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "LEXINGTON",
"MailingAddressStateName": "KY",
"MailingAddressPostalCode": "40507-1409",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "859-537-7332",
"MailingAddressFaxNumber": "859-258-9209",
"FirstLinePracticeLocationAddress": "219 E HIGH ST",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "LEXINGTON",
"PracticeLocationAddressStateName": "KY",
"PracticeLocationAddressPostalCode": "40507-1409",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "859-537-7332",
"PracticeLocationAddressFaxNumber": "859-258-9209",
"EnumerationDate": "04/29/2010",
"LastUpdateDate": "12/23/2019",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "TUTTLE",
"AuthorizedOfficialFirstName": "JEFFREY",
"AuthorizedOfficialMiddleName": null,
"AuthorizedOfficialTitle": "MEMBER",
"AuthorizedOfficialNamePrefix": "DR.",
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "M.D.",
"AuthorizedOfficialTelephoneNumber": "859-537-7332",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "261QM0850X",
"TaxonomyName": "Adult Mental Health Clinic/Center",
"LicenseNumber": "40860",
"LicenseNumberStateCode": "KY",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}