{
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"EIN": null,
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"IsOrgSubpart": "N",
"ParentOrgLBN": null,
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"OrgName": "PRAIRIE FAMILY HEALTHCARE, P.C.",
"LastName": null,
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"MiddleName": null,
"NamePrefix": null,
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"Credential": null,
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"OtherCredential": null,
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"FirstLineMailingAddress": "1115 E 5TH AVE",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "MITCHELL",
"MailingAddressStateName": "SD",
"MailingAddressPostalCode": "57301-2917",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "605-996-5553",
"MailingAddressFaxNumber": "605-996-1213",
"FirstLinePracticeLocationAddress": "1115 E 5TH AVE",
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"PracticeLocationAddressCityName": "MITCHELL",
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"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "605-996-5553",
"PracticeLocationAddressFaxNumber": "605-996-1213",
"EnumerationDate": "12/17/2008",
"LastUpdateDate": "12/17/2008",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "KENKEL",
"AuthorizedOfficialFirstName": "DIANE",
"AuthorizedOfficialMiddleName": "LYNN",
"AuthorizedOfficialTitle": "PRESIDENT",
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"AuthorizedOfficialCredential": "CNP",
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"Taxonomies": {
"Taxonomy": {
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"TaxonomyName": "Clinic/Center",
"LicenseNumber": "CP000190",
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"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}