{
"Npi": {
"NPI": "1457817231",
"EntityType": "Individual",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": "N",
"IsOrgSubpart": null,
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": null,
"LastName": "BREWER",
"FirstName": "JAQURIS",
"MiddleName": "DASHUN",
"NamePrefix": null,
"NameSuffix": null,
"Credential": null,
"OtherOrgName": null,
"OtherOrgNameTypeCode": null,
"OtherLastName": null,
"OtherFirstName": null,
"OtherMiddleName": null,
"OtherNamePrefix": null,
"OtherNameSuffix": null,
"OtherCredential": null,
"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "218 TRAVIS DR",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "LAWRENCEVILLE",
"MailingAddressStateName": "VA",
"MailingAddressPostalCode": "23868-4025",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "434-532-3450",
"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "1037 W 39TH ST",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "NORFOLK",
"PracticeLocationAddressStateName": "VA",
"PracticeLocationAddressPostalCode": "23508-2788",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "434-378-1126",
"PracticeLocationAddressFaxNumber": null,
"EnumerationDate": "02/16/2019",
"LastUpdateDate": "02/16/2019",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": "M",
"Gender": "Male",
"AuthorizedOfficialLastName": null,
"AuthorizedOfficialFirstName": null,
"AuthorizedOfficialMiddleName": null,
"AuthorizedOfficialTitle": null,
"AuthorizedOfficialNamePrefix": null,
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": null,
"AuthorizedOfficialTelephoneNumber": null,
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "172A00000X",
"TaxonomyName": "Driver",
"LicenseNumber": null,
"LicenseNumberStateCode": null,
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}