{
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"ParentOrgLBN": null,
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"NamePrefix": null,
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"FirstLineMailingAddress": "95 S LIBERTY ST",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "POWELL",
"MailingAddressStateName": "OH",
"MailingAddressPostalCode": "43065-9301",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "614-888-2855",
"MailingAddressFaxNumber": "614-888-8576",
"FirstLinePracticeLocationAddress": "95 S LIBERTY ST",
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"PracticeLocationAddressCityName": "POWELL",
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"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "614-888-2855",
"PracticeLocationAddressFaxNumber": "614-888-8576",
"EnumerationDate": "08/01/2006",
"LastUpdateDate": "01/15/2009",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "D'ALANNO",
"AuthorizedOfficialFirstName": "DANA",
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"AuthorizedOfficialNamePrefix": "MRS.",
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"AuthorizedOfficialCredential": null,
"AuthorizedOfficialTelephoneNumber": "614-888-2855",
"Taxonomies": {
"Taxonomy": [
{
"TaxonomyCode": "261QA1903X",
"TaxonomyName": "Ambulatory Surgical Clinic/Center",
"LicenseNumber": null,
"LicenseNumberStateCode": null,
"PrimaryTaxonomySwitch": "N"
},
{
"TaxonomyCode": "174400000X",
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}
]
},
"HealthcareProviderTaxonomyGroups": {
"HealthcareProviderTaxonomyGroup": {
"HealthcareProviderTaxonomyGroupName": "193400000X SINGLE SPECIALTY GROUP",
"HealthcareProviderTaxonomyGroupDescription": "Single Specialty Group - A business group of one or more individual practitioners, all of who practice with the same area of specialization."
}
}
}
}