{
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"FirstLineMailingAddress": "15 LA SALLE SQ",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "PROVIDENCE",
"MailingAddressStateName": "RI",
"MailingAddressPostalCode": "02903-1814",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "401-444-5640",
"MailingAddressFaxNumber": "401-444-5462",
"FirstLinePracticeLocationAddress": "11 FRIENDSHIP ST",
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"PracticeLocationAddressCityName": "NEWPORT",
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"EnumerationDate": "04/30/2007",
"LastUpdateDate": "10/21/2025",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "MARKELL",
"AuthorizedOfficialFirstName": "PETER",
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"AuthorizedOfficialTelephoneNumber": "401-444-7914",
"Taxonomies": {
"Taxonomy": {
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"TaxonomyName": "Cardiology Technician",
"LicenseNumber": "HOS00127",
"LicenseNumberStateCode": "RI",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": {
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"HealthcareProviderTaxonomyGroupDescription": "Single Specialty Group - A business group of one or more individual practitioners, all of who practice with the same area of specialization."
}
}
}
}