{
"Npi": {
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"EIN": null,
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"IsOrgSubpart": "Y",
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"ParentOrgTIN": null,
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"LastName": null,
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"NamePrefix": null,
"NameSuffix": null,
"Credential": null,
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"OtherCredential": null,
"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "1200 UNIVERSITY AVE STE 200",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "DES MOINES",
"MailingAddressStateName": "IA",
"MailingAddressPostalCode": "50314-2355",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "515-248-1447",
"MailingAddressFaxNumber": "515-248-1440",
"FirstLinePracticeLocationAddress": "1200 UNIVERSITY AVE.",
"SecondLinePracticeLocationAddress": "SUITE 105",
"PracticeLocationAddressCityName": "DES MOINES",
"PracticeLocationAddressStateName": "IA",
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"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "515-262-0854",
"PracticeLocationAddressFaxNumber": "515-262-5089",
"EnumerationDate": "02/12/2007",
"LastUpdateDate": "01/07/2026",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "SIMPSON",
"AuthorizedOfficialFirstName": "NATHANIEL",
"AuthorizedOfficialMiddleName": "A",
"AuthorizedOfficialTitle": "CHIEF EXECUTIVE OFFICER",
"AuthorizedOfficialNamePrefix": null,
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": null,
"AuthorizedOfficialTelephoneNumber": "515-248-1441",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "3336C0003X",
"TaxonomyName": "Community/Retail Pharmacy",
"LicenseNumber": "BC8657047",
"LicenseNumberStateCode": "IA",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}