{
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"FirstLineMailingAddress": "3350 S 15TH E",
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"MailingAddressCityName": "IDAHO FALLS",
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"MailingAddressCountryCode": "US",
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"MailingAddressFaxNumber": "208-522-5416",
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"EnumerationDate": "09/07/2012",
"LastUpdateDate": "09/07/2012",
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"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "WOOD",
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"Taxonomies": {
"Taxonomy": {
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"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": {
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}
}
}
}