{
"Npi": {
"NPI": "1912183146",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "DENNIS S. DAVIS",
"LastName": null,
"FirstName": null,
"MiddleName": null,
"NamePrefix": null,
"NameSuffix": null,
"Credential": null,
"OtherOrgName": null,
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"OtherLastName": null,
"OtherFirstName": null,
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"OtherNamePrefix": null,
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"OtherCredential": null,
"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "903 N LINCOLN AVE",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "LOVELAND",
"MailingAddressStateName": "CO",
"MailingAddressPostalCode": "80537-4876",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "970-667-1910",
"MailingAddressFaxNumber": "970-667-1914",
"FirstLinePracticeLocationAddress": "903 N LINCOLN AVE",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "LOVELAND",
"PracticeLocationAddressStateName": "CO",
"PracticeLocationAddressPostalCode": "80537-4876",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "970-667-1910",
"PracticeLocationAddressFaxNumber": "970-667-1914",
"EnumerationDate": "01/17/2008",
"LastUpdateDate": "02/08/2008",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "DAVIS",
"AuthorizedOfficialFirstName": "DENNIS",
"AuthorizedOfficialMiddleName": "SAMUEL",
"AuthorizedOfficialTitle": "PRESIDENT",
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"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "DC",
"AuthorizedOfficialTelephoneNumber": "970-667-1910",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "261QM2500X",
"TaxonomyName": "Medical Specialty Clinic/Center",
"LicenseNumber": "5960",
"LicenseNumberStateCode": "CO",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}