{
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"FirstLineMailingAddress": "7399 N SHADELAND AVE # 103",
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"MailingAddressCityName": "INDIANAPOLIS",
"MailingAddressStateName": "IN",
"MailingAddressPostalCode": "46250-2052",
"MailingAddressCountryCode": "US",
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"FirstLinePracticeLocationAddress": "585 CORNELL AVE",
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"PracticeLocationAddressCityName": "LOVELOCK",
"PracticeLocationAddressStateName": "NV",
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"PracticeLocationAddressCountryCode": "US",
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"EnumerationDate": "07/08/2025",
"LastUpdateDate": "07/08/2025",
"NPIDeactivationReasonCode": null,
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"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "DONADIO",
"AuthorizedOfficialFirstName": "JOSEPH",
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"Taxonomies": {
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"TaxonomyName": "Primary Care Clinic/Center",
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"PrimaryTaxonomySwitch": "Y"
}
},
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}
}