{
"Npi": {
"NPI": "1962977017",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "OURKANSAS GUARDIAN LLC",
"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": "9415 E HARRY ST, STE 605",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "WICHITA",
"MailingAddressStateName": "KS",
"MailingAddressPostalCode": "67207",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "316-448-4250",
"MailingAddressFaxNumber": "316-219-5849",
"FirstLinePracticeLocationAddress": "9415 E HARRY ST, STE 605",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "WICHITA",
"PracticeLocationAddressStateName": "KS",
"PracticeLocationAddressPostalCode": "67207",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "316-448-4250",
"PracticeLocationAddressFaxNumber": null,
"EnumerationDate": "10/04/2018",
"LastUpdateDate": "11/22/2022",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "MBOYA",
"AuthorizedOfficialFirstName": "SIEGFRIED",
"AuthorizedOfficialMiddleName": null,
"AuthorizedOfficialTitle": "DIRECTOR OF NURSING",
"AuthorizedOfficialNamePrefix": "MR.",
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": null,
"AuthorizedOfficialTelephoneNumber": "316-448-4250",
"Taxonomies": {
"Taxonomy": [
{
"TaxonomyCode": "251G00000X",
"TaxonomyName": "Community Based Hospice Care Agency",
"LicenseNumber": null,
"LicenseNumberStateCode": null,
"PrimaryTaxonomySwitch": "N"
},
{
"TaxonomyCode": "251E00000X",
"TaxonomyName": "Home Health Agency",
"LicenseNumber": null,
"LicenseNumberStateCode": null,
"PrimaryTaxonomySwitch": "Y"
}
]
},
"HealthcareProviderTaxonomyGroups": null
}
}