{
"Npi": {
"NPI": "1124128632",
"EntityType": "Individual",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": "Y",
"IsOrgSubpart": null,
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": null,
"LastName": "MCOMIE",
"FirstName": "ELLEN",
"MiddleName": "S",
"NamePrefix": "DR.",
"NameSuffix": null,
"Credential": "MDM",
"OtherOrgName": null,
"OtherOrgNameTypeCode": null,
"OtherLastName": null,
"OtherFirstName": null,
"OtherMiddleName": null,
"OtherNamePrefix": null,
"OtherNameSuffix": null,
"OtherCredential": null,
"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "6450 SOLITUDE DR",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "CHATTANOOGA",
"MailingAddressStateName": "TN",
"MailingAddressPostalCode": "37416-1470",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "423-326-1803",
"MailingAddressFaxNumber": "423-899-1125",
"FirstLinePracticeLocationAddress": "5999 SHALLOWFORD RD",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "CHATTANOOGA",
"PracticeLocationAddressStateName": "TN",
"PracticeLocationAddressPostalCode": "37421-1683",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "423-899-1112",
"PracticeLocationAddressFaxNumber": "423-899-1125",
"EnumerationDate": "09/24/2006",
"LastUpdateDate": "07/08/2007",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": "F",
"Gender": "Female",
"AuthorizedOfficialLastName": null,
"AuthorizedOfficialFirstName": null,
"AuthorizedOfficialMiddleName": null,
"AuthorizedOfficialTitle": null,
"AuthorizedOfficialNamePrefix": null,
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": null,
"AuthorizedOfficialTelephoneNumber": null,
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "122300000X",
"TaxonomyName": "Dentist",
"LicenseNumber": "7522",
"LicenseNumberStateCode": "TN",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}