{
"Npi": {
"NPI": "1447191457",
"EntityType": "Individual",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": "N",
"IsOrgSubpart": null,
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": null,
"LastName": "MADDOX",
"FirstName": "GEORGETTA",
"MiddleName": "L",
"NamePrefix": "MS.",
"NameSuffix": null,
"Credential": "BSN/RN",
"OtherOrgName": null,
"OtherOrgNameTypeCode": null,
"OtherLastName": null,
"OtherFirstName": null,
"OtherMiddleName": null,
"OtherNamePrefix": null,
"OtherNameSuffix": null,
"OtherCredential": null,
"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "814 N 26TH ST",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "MILWAUKEE",
"MailingAddressStateName": "WI",
"MailingAddressPostalCode": "53233-1508",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "414-207-4560",
"MailingAddressFaxNumber": "414-448-6946",
"FirstLinePracticeLocationAddress": "814 N 26TH ST",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "MILWAUKEE",
"PracticeLocationAddressStateName": "WI",
"PracticeLocationAddressPostalCode": "53233-1508",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "414-207-4560",
"PracticeLocationAddressFaxNumber": "414-448-6946",
"EnumerationDate": "04/03/2026",
"LastUpdateDate": "04/03/2026",
"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": "163WH0200X",
"TaxonomyName": "Home Health Registered Nurse",
"LicenseNumber": "264448-30",
"LicenseNumberStateCode": "WI",
"PrimaryTaxonomySwitch": "N"
},
{
"TaxonomyCode": "163WP0000X",
"TaxonomyName": "Pain Management Registered Nurse",
"LicenseNumber": "264448-30",
"LicenseNumberStateCode": "WI",
"PrimaryTaxonomySwitch": "N"
},
{
"TaxonomyCode": "163WC1600X",
"TaxonomyName": "Continuing Education/Staff Development Registered Nurse",
"LicenseNumber": "264448-30",
"LicenseNumberStateCode": "WI",
"PrimaryTaxonomySwitch": "N"
},
{
"TaxonomyCode": "163WP0808X",
"TaxonomyName": "Psychiatric/Mental Health Registered Nurse",
"LicenseNumber": "264448-30",
"LicenseNumberStateCode": "WI",
"PrimaryTaxonomySwitch": "N"
},
{
"TaxonomyCode": "163WP2201X",
"TaxonomyName": "Ambulatory Care Registered Nurse",
"LicenseNumber": "264448-30",
"LicenseNumberStateCode": "WI",
"PrimaryTaxonomySwitch": "N"
},
{
"TaxonomyCode": "251E00000X",
"TaxonomyName": "Home Health Agency",
"LicenseNumber": "1265",
"LicenseNumberStateCode": "WI",
"PrimaryTaxonomySwitch": "N"
},
{
"TaxonomyCode": "163W00000X",
"TaxonomyName": "Registered Nurse",
"LicenseNumber": "264448-30",
"LicenseNumberStateCode": "WI",
"PrimaryTaxonomySwitch": "Y"
},
{
"TaxonomyCode": "163WR0400X",
"TaxonomyName": "Rehabilitation Registered Nurse",
"LicenseNumber": "264448-30",
"LicenseNumberStateCode": "WI",
"PrimaryTaxonomySwitch": "N"
},
{
"TaxonomyCode": "163WW0000X",
"TaxonomyName": "Wound Care Registered Nurse",
"LicenseNumber": "264448-30",
"LicenseNumberStateCode": "WI",
"PrimaryTaxonomySwitch": "N"
},
{
"TaxonomyCode": "163WX0106X",
"TaxonomyName": "Occupational Health Registered Nurse",
"LicenseNumber": "264448-30",
"LicenseNumberStateCode": "WI",
"PrimaryTaxonomySwitch": "N"
},
{
"TaxonomyCode": "163WA2000X",
"TaxonomyName": "Administrator Registered Nurse",
"LicenseNumber": "1265",
"LicenseNumberStateCode": "WI",
"PrimaryTaxonomySwitch": "N"
}
]
},
"HealthcareProviderTaxonomyGroups": null
}
}