{
"Npi": {
"NPI": "1902282239",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "BRIDGER EMERGENCY TRAINING CENTER 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": "2110 HARNISH BLVD STE 1",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "BILLINGS",
"MailingAddressStateName": "MT",
"MailingAddressPostalCode": "59101-6263",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "406-579-7248",
"MailingAddressFaxNumber": "406-656-2132",
"FirstLinePracticeLocationAddress": "2110 HARNISH BLVD STE 1",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "BILLINGS",
"PracticeLocationAddressStateName": "MT",
"PracticeLocationAddressPostalCode": "59101",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "406-579-7248",
"PracticeLocationAddressFaxNumber": "406-656-2132",
"EnumerationDate": "08/10/2015",
"LastUpdateDate": "07/05/2018",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "KELM",
"AuthorizedOfficialFirstName": "JOEL",
"AuthorizedOfficialMiddleName": "JASON",
"AuthorizedOfficialTitle": "OWNER",
"AuthorizedOfficialNamePrefix": null,
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "AEMT",
"AuthorizedOfficialTelephoneNumber": "406-813-8231",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "3416L0300X",
"TaxonomyName": "Land Ambulance",
"LicenseNumber": "330",
"LicenseNumberStateCode": "MT",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}