{
"Npi": {
"NPI": "1518506542",
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"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
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"OrgName": "FAITH MEDICAL GROUP, PLLC",
"LastName": null,
"FirstName": null,
"MiddleName": null,
"NamePrefix": null,
"NameSuffix": null,
"Credential": null,
"OtherOrgName": null,
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"OtherLastName": null,
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"FirstLineMailingAddress": "344 FLEMINGS DR",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "MORRISTOWN",
"MailingAddressStateName": "TN",
"MailingAddressPostalCode": "37813-1031",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "423-312-1402",
"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "500 MCFARLAND ST STE E",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "MORRISTOWN",
"PracticeLocationAddressStateName": "TN",
"PracticeLocationAddressPostalCode": "37814-3992",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "423-353-4508",
"PracticeLocationAddressFaxNumber": "423-353-4573",
"EnumerationDate": "12/20/2019",
"LastUpdateDate": "12/20/2019",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "SMITH",
"AuthorizedOfficialFirstName": "BARBARA",
"AuthorizedOfficialMiddleName": "GAYLE",
"AuthorizedOfficialTitle": "FNP",
"AuthorizedOfficialNamePrefix": "MRS.",
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"AuthorizedOfficialCredential": "FNP",
"AuthorizedOfficialTelephoneNumber": "423-312-1402",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "261QP2300X",
"TaxonomyName": "Primary Care Clinic/Center",
"LicenseNumber": null,
"LicenseNumberStateCode": null,
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}