{
"Npi": {
"NPI": "1922358084",
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"EIN": null,
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"IsOrgSubpart": "N",
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"ParentOrgTIN": null,
"OrgName": "TRINITY PRIMARY CARE CLINIC",
"LastName": null,
"FirstName": null,
"MiddleName": null,
"NamePrefix": null,
"NameSuffix": null,
"Credential": null,
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"OtherCredential": null,
"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "520 W 103RD ST STE 172",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "KANSAS CITY",
"MailingAddressStateName": "MO",
"MailingAddressPostalCode": "64114-4503",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": null,
"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "520 W 103RD ST STE 172",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "KANSAS CITY",
"PracticeLocationAddressStateName": "MO",
"PracticeLocationAddressPostalCode": "64114-4503",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "913-961-1478",
"PracticeLocationAddressFaxNumber": null,
"EnumerationDate": "09/17/2012",
"LastUpdateDate": "09/17/2012",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "ALLEN",
"AuthorizedOfficialFirstName": "TIWANA",
"AuthorizedOfficialMiddleName": null,
"AuthorizedOfficialTitle": "APRN",
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"AuthorizedOfficialCredential": "MSN",
"AuthorizedOfficialTelephoneNumber": "913-961-1478",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "261QP2300X",
"TaxonomyName": "Primary Care Clinic/Center",
"LicenseNumber": "155480",
"LicenseNumberStateCode": "MO",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}