{
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"LastName": null,
"FirstName": null,
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"FirstLineMailingAddress": "PO BOX 1",
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"MailingAddressCityName": "LIMEPORT",
"MailingAddressStateName": "PA",
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"MailingAddressCountryCode": "US",
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"FirstLinePracticeLocationAddress": "1601 LIMEPORT PIKE",
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"PracticeLocationAddressCityName": "COOPERSBURG",
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"PracticeLocationAddressFaxNumber": null,
"EnumerationDate": "10/17/2008",
"LastUpdateDate": "02/19/2009",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "KRUPP",
"AuthorizedOfficialFirstName": "RUSSELL",
"AuthorizedOfficialMiddleName": null,
"AuthorizedOfficialTitle": "BILLING MANAGER",
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"AuthorizedOfficialCredential": null,
"AuthorizedOfficialTelephoneNumber": "610-376-2007",
"Taxonomies": {
"Taxonomy": {
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"TaxonomyName": "Land Ambulance",
"LicenseNumber": null,
"LicenseNumberStateCode": null,
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}