{
"Npi": {
"NPI": "1134528458",
"EntityType": "Individual",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": "Y",
"IsOrgSubpart": null,
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": null,
"LastName": "PALMER",
"FirstName": "ROSSLYN",
"MiddleName": "MICHELLE",
"NamePrefix": "MRS.",
"NameSuffix": null,
"Credential": "DDR TRANSPORTATION",
"OtherOrgName": null,
"OtherOrgNameTypeCode": null,
"OtherLastName": "PALMER",
"OtherFirstName": "DAVID",
"OtherMiddleName": "KEITH",
"OtherNamePrefix": "MR.",
"OtherNameSuffix": null,
"OtherCredential": "DDR TRANSPORTATION",
"OtherLastNameTypeCode": "2",
"FirstLineMailingAddress": "2230 LAKE PARK DR SPC 168",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "SAN JACINTO",
"MailingAddressStateName": "CA",
"MailingAddressPostalCode": "92583-7568",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "951-487-2317",
"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "2230 LAKE PARK DR SPC 168",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "SAN JACINTO",
"PracticeLocationAddressStateName": "CA",
"PracticeLocationAddressPostalCode": "92583-7568",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "951-487-2317",
"PracticeLocationAddressFaxNumber": null,
"EnumerationDate": "08/22/2014",
"LastUpdateDate": "08/22/2014",
"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": "347C00000X",
"TaxonomyName": "Private Vehicle",
"LicenseNumber": "039131",
"LicenseNumberStateCode": "CA",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}