{
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"FirstLineMailingAddress": "PO BOX 2037",
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"MailingAddressCityName": "ROCKY MOUNT",
"MailingAddressStateName": "NC",
"MailingAddressPostalCode": "27802-2037",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "252-544-5031",
"MailingAddressFaxNumber": "252-544-5031",
"FirstLinePracticeLocationAddress": "1713 BEVERLY RD",
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"PracticeLocationAddressCityName": "ROCKY MOUNT",
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"PracticeLocationAddressFaxNumber": "252-544-5031",
"EnumerationDate": "12/17/2012",
"LastUpdateDate": "12/17/2012",
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"NPIDeactivationReason": null,
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"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "OHREE",
"AuthorizedOfficialFirstName": "NATHLYN",
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"AuthorizedOfficialTitle": "PRESIDENT",
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"AuthorizedOfficialCredential": "MA/CCC/SLP",
"AuthorizedOfficialTelephoneNumber": "252-544-5031",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "174400000X",
"TaxonomyName": "Specialist",
"LicenseNumber": "1078",
"LicenseNumberStateCode": "NC",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": {
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"HealthcareProviderTaxonomyGroupName": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
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}
}
}
}