{
"Npi": {
"NPI": "1912969429",
"EntityType": "Individual",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": "N",
"IsOrgSubpart": null,
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": null,
"LastName": "BUDDELMEYER",
"FirstName": "SCOTT",
"MiddleName": "MICHAEL",
"NamePrefix": "MR.",
"NameSuffix": null,
"Credential": "ATC, EMT-B",
"OtherOrgName": null,
"OtherOrgNameTypeCode": null,
"OtherLastName": null,
"OtherFirstName": null,
"OtherMiddleName": null,
"OtherNamePrefix": null,
"OtherNameSuffix": null,
"OtherCredential": null,
"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "422 JOHN ST",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "HOLGATE",
"MailingAddressStateName": "OH",
"MailingAddressPostalCode": "43527-9806",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "419-264-0339",
"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "1400 E 2ND ST",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "DEFIANCE",
"PracticeLocationAddressStateName": "OH",
"PracticeLocationAddressPostalCode": "43512-2440",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "419-783-2791",
"PracticeLocationAddressFaxNumber": null,
"EnumerationDate": "04/03/2006",
"LastUpdateDate": "07/08/2007",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": "M",
"Gender": "Male",
"AuthorizedOfficialLastName": null,
"AuthorizedOfficialFirstName": null,
"AuthorizedOfficialMiddleName": null,
"AuthorizedOfficialTitle": null,
"AuthorizedOfficialNamePrefix": null,
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": null,
"AuthorizedOfficialTelephoneNumber": null,
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "2255A2300X",
"TaxonomyName": "Athletic Trainer",
"LicenseNumber": "022051",
"LicenseNumberStateCode": "OH",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}