{
"Npi": {
"NPI": "1922280353",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "MIRONDA CLEMENTS",
"LastName": null,
"FirstName": null,
"MiddleName": null,
"NamePrefix": null,
"NameSuffix": null,
"Credential": null,
"OtherOrgName": null,
"OtherOrgNameTypeCode": null,
"OtherLastName": null,
"OtherFirstName": null,
"OtherMiddleName": null,
"OtherNamePrefix": null,
"OtherNameSuffix": null,
"OtherCredential": null,
"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "22709 LAKE SHORE BLVD",
"SecondLineMailingAddress": "246C",
"MailingAddressCityName": "EUCLID",
"MailingAddressStateName": "OH",
"MailingAddressPostalCode": "44123-1359",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "216-780-6795",
"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "22709 LAKE SHORE BLVD",
"SecondLinePracticeLocationAddress": "246C",
"PracticeLocationAddressCityName": "EUCLID",
"PracticeLocationAddressStateName": "OH",
"PracticeLocationAddressPostalCode": "44123-1359",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "216-780-6795",
"PracticeLocationAddressFaxNumber": null,
"EnumerationDate": "11/27/2007",
"LastUpdateDate": "12/09/2007",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "CLEMENTS",
"AuthorizedOfficialFirstName": "MIRONDA",
"AuthorizedOfficialMiddleName": "A.",
"AuthorizedOfficialTitle": "LICENSED PRACTICAL NURSE",
"AuthorizedOfficialNamePrefix": null,
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": null,
"AuthorizedOfficialTelephoneNumber": "216-780-6795",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "251J00000X",
"TaxonomyName": "Nursing Care Agency",
"LicenseNumber": "PN-126116 IV",
"LicenseNumberStateCode": "OH",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}