{
"Npi": {
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"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "G & G DIAGNOSTIC, LLC",
"LastName": null,
"FirstName": null,
"MiddleName": null,
"NamePrefix": null,
"NameSuffix": null,
"Credential": null,
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"OtherLastName": null,
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"OtherCredential": null,
"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "373 HAYS BLVD",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "LEXINGTON",
"MailingAddressStateName": "KY",
"MailingAddressPostalCode": "40509-4495",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "859-806-4778",
"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "7410 NEW LAGRANGE RD",
"SecondLinePracticeLocationAddress": "SUITE 202",
"PracticeLocationAddressCityName": "LOUISVILLE",
"PracticeLocationAddressStateName": "KY",
"PracticeLocationAddressPostalCode": "40222",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "859-806-4778",
"PracticeLocationAddressFaxNumber": null,
"EnumerationDate": "06/14/2010",
"LastUpdateDate": "06/14/2010",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "COFFELT",
"AuthorizedOfficialFirstName": "GARY",
"AuthorizedOfficialMiddleName": "D",
"AuthorizedOfficialTitle": "PRESIDENT",
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"AuthorizedOfficialCredential": null,
"AuthorizedOfficialTelephoneNumber": "859-806-4778",
"Taxonomies": {
"Taxonomy": {
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"TaxonomyName": "Private Vehicle",
"LicenseNumber": "C01 508 809",
"LicenseNumberStateCode": "KY",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}