{
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"EIN": null,
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"OrgName": "RENEE E THOMPSON",
"LastName": null,
"FirstName": null,
"MiddleName": null,
"NamePrefix": null,
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"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "4201 MARLA DR NE",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "ALBUQUERQUE",
"MailingAddressStateName": "NM",
"MailingAddressPostalCode": "87109-1937",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "505-401-2945",
"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "4201 MARLA DR NE",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "ALBUQUERQUE",
"PracticeLocationAddressStateName": "NM",
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"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "505-401-2945",
"PracticeLocationAddressFaxNumber": null,
"EnumerationDate": "12/09/2008",
"LastUpdateDate": "12/09/2008",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "THOMPSON",
"AuthorizedOfficialFirstName": "RENEE",
"AuthorizedOfficialMiddleName": "E",
"AuthorizedOfficialTitle": "SOLE PRIORETOR",
"AuthorizedOfficialNamePrefix": null,
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "MD",
"AuthorizedOfficialTelephoneNumber": "505-401-2945",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "208600000X",
"TaxonomyName": "Surgery Physician",
"LicenseNumber": "2006-0100",
"LicenseNumberStateCode": "NM",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": {
"HealthcareProviderTaxonomyGroup": {
"HealthcareProviderTaxonomyGroupName": "193400000X 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."
}
}
}
}