{
"Npi": {
"NPI": "1164673950",
"EntityType": "Individual",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": "N",
"IsOrgSubpart": null,
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": null,
"LastName": "SEITZ",
"FirstName": "ZACHARY",
"MiddleName": "D",
"NamePrefix": "MR.",
"NameSuffix": null,
"Credential": "PA-C",
"OtherOrgName": null,
"OtherOrgNameTypeCode": null,
"OtherLastName": null,
"OtherFirstName": null,
"OtherMiddleName": null,
"OtherNamePrefix": null,
"OtherNameSuffix": null,
"OtherCredential": null,
"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "8605 REINDEER MOSS DR",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "WAKE FOREST",
"MailingAddressStateName": "NC",
"MailingAddressPostalCode": "27587-4837",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "814-243-2513",
"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "1911 FALLS VALLEY DR STE 100",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "RALEIGH",
"PracticeLocationAddressStateName": "NC",
"PracticeLocationAddressPostalCode": "27615-2496",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "919-846-3522",
"PracticeLocationAddressFaxNumber": null,
"EnumerationDate": "10/10/2008",
"LastUpdateDate": "05/31/2019",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": "M",
"Gender": "Male",
"AuthorizedOfficialLastName": null,
"AuthorizedOfficialFirstName": null,
"AuthorizedOfficialMiddleName": null,
"AuthorizedOfficialTitle": null,
"AuthorizedOfficialNamePrefix": null,
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": null,
"AuthorizedOfficialTelephoneNumber": null,
"Taxonomies": {
"Taxonomy": [
{
"TaxonomyCode": "363AM0700X",
"TaxonomyName": "Medical Physician Assistant",
"LicenseNumber": "MA053631",
"LicenseNumberStateCode": "PA",
"PrimaryTaxonomySwitch": "N"
},
{
"TaxonomyCode": "363A00000X",
"TaxonomyName": "Physician Assistant",
"LicenseNumber": "001004572",
"LicenseNumberStateCode": "NC",
"PrimaryTaxonomySwitch": "Y"
}
]
},
"HealthcareProviderTaxonomyGroups": null
}
}