{
"Npi": {
"NPI": "1215958079",
"EntityType": "Individual",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": "Y",
"IsOrgSubpart": null,
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": null,
"LastName": "MARTIN",
"FirstName": "ROBERT",
"MiddleName": "LEWIS",
"NamePrefix": "DR.",
"NameSuffix": "SR.",
"Credential": "MD",
"OtherOrgName": null,
"OtherOrgNameTypeCode": null,
"OtherLastName": "MARTIN",
"OtherFirstName": "ROBERT",
"OtherMiddleName": "LEWIS",
"OtherNamePrefix": "MR.",
"OtherNameSuffix": "I",
"OtherCredential": "M.D.",
"OtherLastNameTypeCode": "2",
"FirstLineMailingAddress": "67-1268 KAMALOO ST",
"SecondLineMailingAddress": "UNIT 7",
"MailingAddressCityName": "KAMUELA",
"MailingAddressStateName": "HI",
"MailingAddressPostalCode": "96743-8389",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "808-754-2154",
"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "65-1267 KAWAIHAE RD",
"SecondLinePracticeLocationAddress": "WAIANAE COAST COMPREHENSIVE HEALTH CENTER",
"PracticeLocationAddressCityName": "KAMUELA",
"PracticeLocationAddressStateName": "HI",
"PracticeLocationAddressPostalCode": "96743-7345",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "808-696-7081",
"PracticeLocationAddressFaxNumber": null,
"EnumerationDate": "07/21/2006",
"LastUpdateDate": "10/24/2012",
"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": "208D00000X",
"TaxonomyName": "General Practice Physician",
"LicenseNumber": "9072",
"LicenseNumberStateCode": "HI",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}