{
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"FirstLineMailingAddress": "8670 WOLFF CT # 270",
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"MailingAddressCityName": "WESTMINSTER",
"MailingAddressStateName": "CO",
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"MailingAddressCountryCode": "US",
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"MailingAddressFaxNumber": "800-247-9785",
"FirstLinePracticeLocationAddress": "1240 S PARKER RD STE 100",
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"PracticeLocationAddressCityName": "DENVER",
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"EnumerationDate": "08/27/2015",
"LastUpdateDate": "03/26/2025",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
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"AuthorizedOfficialLastName": "BONNETT",
"AuthorizedOfficialFirstName": "CARL",
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"AuthorizedOfficialCredential": "M.D.",
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"Taxonomies": {
"Taxonomy": {
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"TaxonomyName": "General Practice Physician",
"LicenseNumber": "P8449",
"LicenseNumberStateCode": "TX",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": {
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"HealthcareProviderTaxonomyGroupDescription": "Single Specialty Group - A business group of one or more individual practitioners, all of who practice with the same area of specialization."
}
}
}
}