{
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"FirstLineMailingAddress": "1730 HENDERSON ST",
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"MailingAddressCityName": "COLUMBIA",
"MailingAddressStateName": "SC",
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"PracticeLocationAddressFaxNumber": "803-799-6434",
"EnumerationDate": "02/23/2015",
"LastUpdateDate": "02/23/2015",
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"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "THOMPSON",
"AuthorizedOfficialFirstName": "HERMAN",
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"AuthorizedOfficialTelephoneNumber": "803-765-2600",
"Taxonomies": {
"Taxonomy": {
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"TaxonomyName": "Dermatology Physician",
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"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": {
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}
}
}
}