{
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"FirstLineMailingAddress": "PO BOX 1266",
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"MailingAddressStateName": "NC",
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"FirstLinePracticeLocationAddress": "310 S BENNETT ST",
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"EnumerationDate": "08/11/2006",
"LastUpdateDate": "06/18/2008",
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"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "WECKEL",
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"AuthorizedOfficialMiddleName": "MONTY",
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"AuthorizedOfficialCredential": "M.D.",
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"Taxonomies": {
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"TaxonomyName": "Family Medicine Physician",
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"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."
}
}
}
}