{
"Npi": {
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"EIN": null,
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"IsOrgSubpart": "N",
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"OrgName": "KEITH M DOCKERY, MD PC",
"LastName": null,
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"NamePrefix": null,
"NameSuffix": null,
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"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "1800 PEACHTREE ST NW",
"SecondLineMailingAddress": "SUITE 700",
"MailingAddressCityName": "ATLANTA",
"MailingAddressStateName": "GA",
"MailingAddressPostalCode": "30309-2519",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "404-350-7966",
"MailingAddressFaxNumber": "404-350-7968",
"FirstLinePracticeLocationAddress": "1800 PEACHTREE ST NW",
"SecondLinePracticeLocationAddress": "SUITE 700",
"PracticeLocationAddressCityName": "ATLANTA",
"PracticeLocationAddressStateName": "GA",
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"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "404-350-7966",
"PracticeLocationAddressFaxNumber": "404-350-7968",
"EnumerationDate": "08/29/2007",
"LastUpdateDate": "03/22/2011",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "DILL",
"AuthorizedOfficialFirstName": "MELISSA",
"AuthorizedOfficialMiddleName": "PARKS",
"AuthorizedOfficialTitle": "PRACTICE MANAGER",
"AuthorizedOfficialNamePrefix": "MS.",
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": null,
"AuthorizedOfficialTelephoneNumber": "404-350-7966",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "231H00000X",
"TaxonomyName": "Audiologist",
"LicenseNumber": "AUD003711",
"LicenseNumberStateCode": "GA",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": {
"HealthcareProviderTaxonomyGroup": {
"HealthcareProviderTaxonomyGroupName": "193400000X SINGLE SPECIALTY GROUP",
"HealthcareProviderTaxonomyGroupDescription": "Single Specialty Group - A business group of one or more individual practitioners, all of who practice with the same area of specialization."
}
}
}
}