{
"Npi": {
"NPI": "1922388123",
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"EIN": null,
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"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "TE DEO, LLC",
"LastName": null,
"FirstName": null,
"MiddleName": null,
"NamePrefix": null,
"NameSuffix": null,
"Credential": null,
"OtherOrgName": null,
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"OtherLastName": null,
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"OtherNamePrefix": null,
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"OtherCredential": null,
"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "10374 155TH ST",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "GLENCOE",
"MailingAddressStateName": "MN",
"MailingAddressPostalCode": "55336-7502",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "612-240-0054",
"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "627 12TH ST E",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "GLENCOE",
"PracticeLocationAddressStateName": "MN",
"PracticeLocationAddressPostalCode": "55336-2133",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "320-864-8000",
"PracticeLocationAddressFaxNumber": "320-864-8004",
"EnumerationDate": "08/19/2011",
"LastUpdateDate": "08/19/2011",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "KRAMER",
"AuthorizedOfficialFirstName": "KURT",
"AuthorizedOfficialMiddleName": "DONALD",
"AuthorizedOfficialTitle": "OWNER",
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"AuthorizedOfficialCredential": "STM, DC",
"AuthorizedOfficialTelephoneNumber": "612-240-0054",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "261QM2500X",
"TaxonomyName": "Medical Specialty Clinic/Center",
"LicenseNumber": "5391",
"LicenseNumberStateCode": "MN",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}