{
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"FirstLineMailingAddress": "936A GENERAL BOOTH BLVD",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "VIRGINIA BEACH",
"MailingAddressStateName": "VA",
"MailingAddressPostalCode": "23451-4857",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "757-228-1955",
"MailingAddressFaxNumber": "757-228-3095",
"FirstLinePracticeLocationAddress": "902A GRAYDON AVE",
"SecondLinePracticeLocationAddress": "PODIATRY",
"PracticeLocationAddressCityName": "NORFOLK",
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"PracticeLocationAddressTelephoneNumber": "757-962-4991",
"PracticeLocationAddressFaxNumber": "757-962-5993",
"EnumerationDate": "12/15/2010",
"LastUpdateDate": "12/15/2010",
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"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "FELD",
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"AuthorizedOfficialTelephoneNumber": "757-962-4991",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "332B00000X",
"TaxonomyName": "Durable Medical Equipment & Medical Supplies",
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"LicenseNumberStateCode": null,
"PrimaryTaxonomySwitch": "Y"
}
},
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}
}