{
"Npi": {
"NPI": "1366735946",
"EntityType": "Individual",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": "N",
"IsOrgSubpart": null,
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": null,
"LastName": "BOX",
"FirstName": "SHEA",
"MiddleName": "ANN",
"NamePrefix": "MRS.",
"NameSuffix": null,
"Credential": "PA-C",
"OtherOrgName": null,
"OtherOrgNameTypeCode": null,
"OtherLastName": "WRIGHT",
"OtherFirstName": "SHEA",
"OtherMiddleName": "ANN",
"OtherNamePrefix": "MS.",
"OtherNameSuffix": null,
"OtherCredential": "PA-C",
"OtherLastNameTypeCode": "1",
"FirstLineMailingAddress": "294 LELAND TER NE",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "ATLANTA",
"MailingAddressStateName": "GA",
"MailingAddressPostalCode": "30317-1409",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "512-560-1337",
"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "80 JESSE HILL JR DR SE",
"SecondLinePracticeLocationAddress": "SUITE D-332",
"PracticeLocationAddressCityName": "ATLANTA",
"PracticeLocationAddressStateName": "GA",
"PracticeLocationAddressPostalCode": "30303-3031",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "404-616-7257",
"PracticeLocationAddressFaxNumber": null,
"EnumerationDate": "05/16/2011",
"LastUpdateDate": "08/15/2017",
"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": "363AS0400X",
"TaxonomyName": "Surgical Physician Assistant",
"LicenseNumber": "6110",
"LicenseNumberStateCode": "GA",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}