{
"Npi": {
"NPI": "1194743302",
"EntityType": "Individual",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": "N",
"IsOrgSubpart": null,
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": null,
"LastName": "GILLIARD",
"FirstName": "TAWANNA",
"MiddleName": "OPAL",
"NamePrefix": "DR.",
"NameSuffix": null,
"Credential": "M.D.",
"OtherOrgName": null,
"OtherOrgNameTypeCode": null,
"OtherLastName": "GORDON",
"OtherFirstName": "TAWANNA",
"OtherMiddleName": "O",
"OtherNamePrefix": "DR.",
"OtherNameSuffix": null,
"OtherCredential": "M.D.",
"OtherLastNameTypeCode": "1",
"FirstLineMailingAddress": "7130 GLEN FOREST DR",
"SecondLineMailingAddress": "SUITE 101",
"MailingAddressCityName": "RICHMOND",
"MailingAddressStateName": "VA",
"MailingAddressPostalCode": "23226-3754",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "804-282-1095",
"MailingAddressFaxNumber": "804-282-8678",
"FirstLinePracticeLocationAddress": "7611 FOREST AVE",
"SecondLinePracticeLocationAddress": "SUITE 200",
"PracticeLocationAddressCityName": "RICHMOND",
"PracticeLocationAddressStateName": "VA",
"PracticeLocationAddressPostalCode": "23229-4946",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "804-288-4084",
"PracticeLocationAddressFaxNumber": "804-288-3567",
"EnumerationDate": "07/17/2006",
"LastUpdateDate": "03/07/2023",
"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": "207V00000X",
"TaxonomyName": "Obstetrics & Gynecology Physician",
"LicenseNumber": "055753",
"LicenseNumberStateCode": "GA",
"PrimaryTaxonomySwitch": "N"
},
{
"TaxonomyCode": "207V00000X",
"TaxonomyName": "Obstetrics & Gynecology Physician",
"LicenseNumber": "0101244776",
"LicenseNumberStateCode": "VA",
"PrimaryTaxonomySwitch": "Y"
},
{
"TaxonomyCode": "207V00000X",
"TaxonomyName": "Obstetrics & Gynecology Physician",
"LicenseNumber": "MD424859",
"LicenseNumberStateCode": "PA",
"PrimaryTaxonomySwitch": "N"
}
]
},
"HealthcareProviderTaxonomyGroups": null
}
}