{
"Npi": {
"NPI": "1346552148",
"EntityType": "Individual",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": "N",
"IsOrgSubpart": null,
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": null,
"LastName": "RODRIGUEZ",
"FirstName": "VIRGINCITA",
"MiddleName": "FUENTES",
"NamePrefix": "DR.",
"NameSuffix": null,
"Credential": "M.D.",
"OtherOrgName": null,
"OtherOrgNameTypeCode": null,
"OtherLastName": "FUENTES-RODRIGUEZ",
"OtherFirstName": "VIRGINCITA",
"OtherMiddleName": "FERRY",
"OtherNamePrefix": "DR.",
"OtherNameSuffix": null,
"OtherCredential": "M.D.",
"OtherLastNameTypeCode": "2",
"FirstLineMailingAddress": "2000 MCLAIN ST STE B",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "NEWPORT",
"MailingAddressStateName": "AR",
"MailingAddressPostalCode": "72112-3661",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "870-523-7563",
"MailingAddressFaxNumber": "870-523-2407",
"FirstLinePracticeLocationAddress": "2000 MCLAIN ST STE B",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "NEWPORT",
"PracticeLocationAddressStateName": "AR",
"PracticeLocationAddressPostalCode": "72112-3661",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "870-523-7563",
"PracticeLocationAddressFaxNumber": "870-523-2407",
"EnumerationDate": "07/08/2010",
"LastUpdateDate": "11/18/2020",
"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": "207Q00000X",
"TaxonomyName": "Family Medicine Physician",
"LicenseNumber": "E-7959",
"LicenseNumberStateCode": "AR",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}