{
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"FirstLineMailingAddress": "PO BOX 313",
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"MailingAddressCityName": "APTOS",
"MailingAddressStateName": "CA",
"MailingAddressPostalCode": "95001-0313",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "831-688-6263",
"MailingAddressFaxNumber": "831-688-6263",
"FirstLinePracticeLocationAddress": "7413 MESA DR",
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"PracticeLocationAddressCityName": "APTOS",
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"PracticeLocationAddressFaxNumber": "831-688-6263",
"EnumerationDate": "03/29/2010",
"LastUpdateDate": "03/29/2010",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "LOWE",
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"AuthorizedOfficialMiddleName": "S.",
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"AuthorizedOfficialCredential": "M.D.",
"AuthorizedOfficialTelephoneNumber": "831-688-6263",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "208600000X",
"TaxonomyName": "Surgery Physician",
"LicenseNumber": "G102190",
"LicenseNumberStateCode": "CA",
"PrimaryTaxonomySwitch": "Y"
}
},
"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."
}
}
}
}