{
"Npi": {
"NPI": "1336227958",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "CARY ADULT MEDICINE PLLC",
"LastName": null,
"FirstName": null,
"MiddleName": null,
"NamePrefix": null,
"NameSuffix": null,
"Credential": null,
"OtherOrgName": null,
"OtherOrgNameTypeCode": "6",
"OtherLastName": null,
"OtherFirstName": null,
"OtherMiddleName": null,
"OtherNamePrefix": null,
"OtherNameSuffix": null,
"OtherCredential": null,
"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "930 SE CARY PARKWAY",
"SecondLineMailingAddress": "SUITE 200",
"MailingAddressCityName": "CARY",
"MailingAddressStateName": "NC",
"MailingAddressPostalCode": "27518",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "919-859-2566",
"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "930 SE CARY PARKWAY",
"SecondLinePracticeLocationAddress": "SUITE 200",
"PracticeLocationAddressCityName": "CARY",
"PracticeLocationAddressStateName": "NC",
"PracticeLocationAddressPostalCode": "27518",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "919-859-2566",
"PracticeLocationAddressFaxNumber": null,
"EnumerationDate": "11/01/2006",
"LastUpdateDate": "08/22/2020",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "RESNIK",
"AuthorizedOfficialFirstName": "ROBERT",
"AuthorizedOfficialMiddleName": "JOHN",
"AuthorizedOfficialTitle": "DIRECTOR",
"AuthorizedOfficialNamePrefix": null,
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "MD",
"AuthorizedOfficialTelephoneNumber": "919-859-2566",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "261Q00000X",
"TaxonomyName": "Clinic/Center",
"LicenseNumber": "38831",
"LicenseNumberStateCode": "NC",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}