{
"Npi": {
"NPI": "1255960217",
"EntityType": "Individual",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": "N",
"IsOrgSubpart": null,
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": null,
"LastName": "HESSE",
"FirstName": "MATILDA",
"MiddleName": "ADOBEA",
"NamePrefix": null,
"NameSuffix": null,
"Credential": "MD",
"OtherOrgName": null,
"OtherOrgNameTypeCode": null,
"OtherLastName": null,
"OtherFirstName": null,
"OtherMiddleName": null,
"OtherNamePrefix": null,
"OtherNameSuffix": null,
"OtherCredential": null,
"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "5828 BROADWAY ST APT 827",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "LANCASTER",
"MailingAddressStateName": "NY",
"MailingAddressPostalCode": "14086-9245",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "646-301-4095",
"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "1005 DR. D.B. TODD JR. BOULEVARD",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "NASHVILLE",
"PracticeLocationAddressStateName": "TN",
"PracticeLocationAddressPostalCode": "37208",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "615-327-6277",
"PracticeLocationAddressFaxNumber": "615-327-6733",
"EnumerationDate": "04/02/2020",
"LastUpdateDate": "08/08/2023",
"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": "207R00000X",
"TaxonomyName": "Internal Medicine Physician",
"LicenseNumber": "MD481767",
"LicenseNumberStateCode": "PA",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}