{
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"FirstLineMailingAddress": "1649 BRICE ROAD",
"SecondLineMailingAddress": "SUITE C",
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"MailingAddressCountryCode": "US",
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"FirstLinePracticeLocationAddress": "1649 BRICE RD",
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"EnumerationDate": "08/08/2012",
"LastUpdateDate": "08/09/2012",
"NPIDeactivationReasonCode": null,
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"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "CAMPBELL",
"AuthorizedOfficialFirstName": "STEVEN",
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"AuthorizedOfficialCredential": "NCB-HIS",
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"Taxonomies": {
"Taxonomy": [
{
"TaxonomyCode": "237700000X",
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},
{
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}
]
},
"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."
}
}
}
}