{
"Npi": {
"NPI": "1235314303",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "WENDY E MARTIN",
"LastName": null,
"FirstName": null,
"MiddleName": null,
"NamePrefix": null,
"NameSuffix": null,
"Credential": null,
"OtherOrgName": null,
"OtherOrgNameTypeCode": "6",
"OtherLastName": null,
"OtherFirstName": null,
"OtherMiddleName": null,
"OtherNamePrefix": null,
"OtherNameSuffix": null,
"OtherCredential": null,
"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "8736 S MAIN ST",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "POLAND",
"MailingAddressStateName": "NY",
"MailingAddressPostalCode": "13431-2305",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "315-624-3491",
"MailingAddressFaxNumber": "315-624-3478",
"FirstLinePracticeLocationAddress": "525 FRENCH RD.",
"SecondLinePracticeLocationAddress": "CONMED HEALTH CENTER",
"PracticeLocationAddressCityName": "UTICA",
"PracticeLocationAddressStateName": "NY",
"PracticeLocationAddressPostalCode": "13502",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "315-624-3491",
"PracticeLocationAddressFaxNumber": "315-624-3478",
"EnumerationDate": "01/08/2008",
"LastUpdateDate": "03/07/2023",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "MARTIN",
"AuthorizedOfficialFirstName": "WENDY",
"AuthorizedOfficialMiddleName": "EVELYN",
"AuthorizedOfficialTitle": "ADULT NURSE PRACTITIONER",
"AuthorizedOfficialNamePrefix": "MRS.",
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "RN MSN ANP",
"AuthorizedOfficialTelephoneNumber": "315-895-4050",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "261QH0100X",
"TaxonomyName": "Health Service Clinic/Center",
"LicenseNumber": "F302575",
"LicenseNumberStateCode": "NY",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}