{
"Npi": {
"NPI": "1215346408",
"EntityType": "Individual",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": "N",
"IsOrgSubpart": null,
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": null,
"LastName": "GERGELY",
"FirstName": "MALLORY",
"MiddleName": "NICOLE",
"NamePrefix": "MRS.",
"NameSuffix": null,
"Credential": null,
"OtherOrgName": null,
"OtherOrgNameTypeCode": null,
"OtherLastName": "GALLUCCI",
"OtherFirstName": "MALLORY",
"OtherMiddleName": "NICOLE",
"OtherNamePrefix": "MISS",
"OtherNameSuffix": null,
"OtherCredential": null,
"OtherLastNameTypeCode": "1",
"FirstLineMailingAddress": "520 JEFFERSON AVE",
"SecondLineMailingAddress": "SUITE 400",
"MailingAddressCityName": "JEANNETTE",
"MailingAddressStateName": "PA",
"MailingAddressPostalCode": "15644-2538",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "724-527-8060",
"MailingAddressFaxNumber": "724-522-4002",
"FirstLinePracticeLocationAddress": "1010 LIGONIER ST",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "LATROBE",
"PracticeLocationAddressStateName": "PA",
"PracticeLocationAddressPostalCode": "15650-1846",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "724-589-8581",
"PracticeLocationAddressFaxNumber": "724-539-2739",
"EnumerationDate": "08/13/2014",
"LastUpdateDate": "01/24/2017",
"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": "363LF0000X",
"TaxonomyName": "Family Nurse Practitioner",
"LicenseNumber": "SP014096",
"LicenseNumberStateCode": "PA",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}