{
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"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
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"OrgName": "CHARLES M DEMPSEY MD PLC",
"LastName": null,
"FirstName": null,
"MiddleName": null,
"NamePrefix": null,
"NameSuffix": null,
"Credential": null,
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"OtherOrgNameTypeCode": "6",
"OtherLastName": null,
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"OtherCredential": null,
"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "PO BOX 15689",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "BROOKSVILLE",
"MailingAddressStateName": "FL",
"MailingAddressPostalCode": "34604-0122",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "352-678-5516",
"MailingAddressFaxNumber": "352-678-5518",
"FirstLinePracticeLocationAddress": "12228 CORTEZ BLVD",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "BROOKSVILLE",
"PracticeLocationAddressStateName": "FL",
"PracticeLocationAddressPostalCode": "34613-2631",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "352-678-5516",
"PracticeLocationAddressFaxNumber": "352-678-5518",
"EnumerationDate": "03/30/2007",
"LastUpdateDate": "05/22/2012",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "DEMPSEY",
"AuthorizedOfficialFirstName": "CHARLES",
"AuthorizedOfficialMiddleName": "M",
"AuthorizedOfficialTitle": "PRESIDENT CEO",
"AuthorizedOfficialNamePrefix": "DR.",
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "MD",
"AuthorizedOfficialTelephoneNumber": "352-678-5516",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "208100000X",
"TaxonomyName": "Physical Medicine & Rehabilitation Physician",
"LicenseNumber": "ME82485",
"LicenseNumberStateCode": "FL",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": {
"HealthcareProviderTaxonomyGroup": {
"HealthcareProviderTaxonomyGroupName": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
"HealthcareProviderTaxonomyGroupDescription": "Single Specialty Group - A business group of one or more individual practitioners, all of who practice with the same area of specialization."
}
}
}
}