{
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"FirstLineMailingAddress": "6 LONGMEADOW VILLAGE DR",
"SecondLineMailingAddress": "SUITE 1",
"MailingAddressCityName": "NILES",
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"MailingAddressPostalCode": "49120-7810",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "269-684-3028",
"MailingAddressFaxNumber": "268-684-5291",
"FirstLinePracticeLocationAddress": "6 LONGMEADOW VILLAGE DR",
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"PracticeLocationAddressFaxNumber": "268-684-5291",
"EnumerationDate": "10/10/2007",
"LastUpdateDate": "10/10/2007",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "GRANNELL",
"AuthorizedOfficialFirstName": "JAMES",
"AuthorizedOfficialMiddleName": "MICHAEL",
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"AuthorizedOfficialCredential": "D.O.",
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"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "207X00000X",
"TaxonomyName": "Orthopaedic Surgery Physician",
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"LicenseNumberStateCode": "MI",
"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."
}
}
}
}