{
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"FirstLineMailingAddress": "938 POWELL AVE",
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"EnumerationDate": "06/26/2015",
"LastUpdateDate": "03/22/2016",
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"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "BOGUSZ",
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"AuthorizedOfficialCredential": "D.P.M.",
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"Taxonomies": {
"Taxonomy": {
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"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": {
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}
}
}
}