{
"Npi": {
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"EIN": null,
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"IsOrgSubpart": null,
"ParentOrgLBN": null,
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"OrgName": null,
"LastName": "BURGESS",
"FirstName": "JOHN",
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"NamePrefix": "MR.",
"NameSuffix": null,
"Credential": "HA",
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"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "2125 S BROADWAY",
"SecondLineMailingAddress": "SUITE 111",
"MailingAddressCityName": "SANTA MARIA",
"MailingAddressStateName": "CA",
"MailingAddressPostalCode": "93454",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "805-922-2884",
"MailingAddressFaxNumber": "805-922-2844",
"FirstLinePracticeLocationAddress": "2125 S BROADWAY",
"SecondLinePracticeLocationAddress": "SUITE 111",
"PracticeLocationAddressCityName": "SANTA MARIA",
"PracticeLocationAddressStateName": "CA",
"PracticeLocationAddressPostalCode": "93454",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "805-922-2884",
"PracticeLocationAddressFaxNumber": "805-922-2844",
"EnumerationDate": "07/15/2014",
"LastUpdateDate": "04/16/2019",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": "M",
"Gender": "Male",
"AuthorizedOfficialLastName": null,
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"AuthorizedOfficialTitle": null,
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"AuthorizedOfficialCredential": null,
"AuthorizedOfficialTelephoneNumber": null,
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "237700000X",
"TaxonomyName": "Hearing Instrument Specialist",
"LicenseNumber": "HA3643",
"LicenseNumberStateCode": "CA",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}