{
"Npi": {
"NPI": "1326234253",
"EntityType": "Individual",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": "Y",
"IsOrgSubpart": null,
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": null,
"LastName": "MAYO",
"FirstName": "DONNA",
"MiddleName": "K.",
"NamePrefix": "MRS.",
"NameSuffix": null,
"Credential": "PA-C",
"OtherOrgName": null,
"OtherOrgNameTypeCode": null,
"OtherLastName": null,
"OtherFirstName": null,
"OtherMiddleName": null,
"OtherNamePrefix": null,
"OtherNameSuffix": null,
"OtherCredential": null,
"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "302 UNIVERSITY PARKWAY",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "AIKEN",
"MailingAddressStateName": "SC",
"MailingAddressPostalCode": "29801-2792",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "803-641-5651",
"MailingAddressFaxNumber": "803-641-5625",
"FirstLinePracticeLocationAddress": "302 UNIVERSITY PARKWAY",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "AIKEN",
"PracticeLocationAddressStateName": "SC",
"PracticeLocationAddressPostalCode": "29801-2792",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "803-641-5661",
"PracticeLocationAddressFaxNumber": "803-641-5625",
"EnumerationDate": "09/25/2007",
"LastUpdateDate": "11/20/2013",
"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": "363A00000X",
"TaxonomyName": "Physician Assistant",
"LicenseNumber": "1360",
"LicenseNumberStateCode": "SC",
"PrimaryTaxonomySwitch": "Y"
},
{
"TaxonomyCode": "363A00000X",
"TaxonomyName": "Physician Assistant",
"LicenseNumber": "085003050",
"LicenseNumberStateCode": "IL",
"PrimaryTaxonomySwitch": "N"
}
]
},
"HealthcareProviderTaxonomyGroups": null
}
}