{
"Npi": {
"NPI": "1225034721",
"EntityType": "Individual",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": "N",
"IsOrgSubpart": null,
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": null,
"LastName": "WILSON",
"FirstName": "TONYA",
"MiddleName": "HENRY",
"NamePrefix": "MRS.",
"NameSuffix": null,
"Credential": "ANP",
"OtherOrgName": null,
"OtherOrgNameTypeCode": null,
"OtherLastName": "SMITH",
"OtherFirstName": "TONYA",
"OtherMiddleName": "HENRY",
"OtherNamePrefix": "MS.",
"OtherNameSuffix": null,
"OtherCredential": null,
"OtherLastNameTypeCode": "1",
"FirstLineMailingAddress": "PO BOX 3889",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "JOHNSON CITY",
"MailingAddressStateName": "TN",
"MailingAddressPostalCode": "37602-3889",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "423-794-2450",
"MailingAddressFaxNumber": "423-283-9480",
"FirstLinePracticeLocationAddress": "301 MED TECH PKWY STE 200",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "JOHNSON CITY",
"PracticeLocationAddressStateName": "TN",
"PracticeLocationAddressPostalCode": "37604-2364",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "423-794-1300",
"PracticeLocationAddressFaxNumber": "423-794-1820",
"EnumerationDate": "06/21/2005",
"LastUpdateDate": "01/20/2016",
"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": "363L00000X",
"TaxonomyName": "Nurse Practitioner",
"LicenseNumber": "7633",
"LicenseNumberStateCode": "TN",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}