{
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"FirstLineMailingAddress": "PO BOX 1255",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "LAKE PLACID",
"MailingAddressStateName": "NY",
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"MailingAddressCountryCode": "US",
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"FirstLinePracticeLocationAddress": "6018 SENTINEL RD",
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"PracticeLocationAddressCityName": "LAKE PLACID",
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"EnumerationDate": "04/21/2016",
"LastUpdateDate": "12/08/2016",
"NPIDeactivationReasonCode": null,
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"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "CLAUSS",
"AuthorizedOfficialFirstName": "RHIANNON",
"AuthorizedOfficialMiddleName": null,
"AuthorizedOfficialTitle": "OFFICE MANAGER",
"AuthorizedOfficialNamePrefix": "DR.",
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"AuthorizedOfficialCredential": "D.C.",
"AuthorizedOfficialTelephoneNumber": "404-210-8717",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "111N00000X",
"TaxonomyName": "Chiropractor",
"LicenseNumber": null,
"LicenseNumberStateCode": null,
"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."
}
}
}
}