{
"Npi": {
"NPI": "1245478569",
"EntityType": "Individual",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": "Y",
"IsOrgSubpart": null,
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": null,
"LastName": "WHITE",
"FirstName": "ANDREA",
"MiddleName": "TERESE",
"NamePrefix": "MISS",
"NameSuffix": null,
"Credential": "RN",
"OtherOrgName": null,
"OtherOrgNameTypeCode": null,
"OtherLastName": null,
"OtherFirstName": null,
"OtherMiddleName": null,
"OtherNamePrefix": null,
"OtherNameSuffix": null,
"OtherCredential": null,
"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "4805 CHERRING DRIVE",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "ATLANTA",
"MailingAddressStateName": "GA",
"MailingAddressPostalCode": "30338",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "770-458-7582",
"MailingAddressFaxNumber": "770-544-2221",
"FirstLinePracticeLocationAddress": "5780 PEACHTREE DUNWOODY ROAD",
"SecondLinePracticeLocationAddress": "SUITE 195",
"PracticeLocationAddressCityName": "ATLANTA",
"PracticeLocationAddressStateName": "GA",
"PracticeLocationAddressPostalCode": "30342",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "770-544-2226",
"PracticeLocationAddressFaxNumber": "770-544-2221",
"EnumerationDate": "01/23/2009",
"LastUpdateDate": "01/23/2009",
"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": "261QA1903X",
"TaxonomyName": "Ambulatory Surgical Clinic/Center",
"LicenseNumber": "RN061046",
"LicenseNumberStateCode": "GA",
"PrimaryTaxonomySwitch": "Y"
},
{
"TaxonomyCode": "282N00000X",
"TaxonomyName": "General Acute Care Hospital",
"LicenseNumber": "RN061046",
"LicenseNumberStateCode": "GA",
"PrimaryTaxonomySwitch": "N"
}
]
},
"HealthcareProviderTaxonomyGroups": null
}
}