{
"Npi": {
"NPI": "1538319041",
"EntityType": "Individual",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": "N",
"IsOrgSubpart": null,
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": null,
"LastName": "BAUMGARTNER",
"FirstName": "MERRITT",
"MiddleName": "LEIGH",
"NamePrefix": null,
"NameSuffix": null,
"Credential": "PA-C",
"OtherOrgName": null,
"OtherOrgNameTypeCode": null,
"OtherLastName": null,
"OtherFirstName": null,
"OtherMiddleName": null,
"OtherNamePrefix": null,
"OtherNameSuffix": null,
"OtherCredential": null,
"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "1773 TYRONE ST",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "CROFTON",
"MailingAddressStateName": "MD",
"MailingAddressPostalCode": "21114-2521",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "901-827-8902",
"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "1071 MD RT 3 N",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "GAMBRILLS",
"PracticeLocationAddressStateName": "MD",
"PracticeLocationAddressPostalCode": "21054-1784",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "410-721-2333",
"PracticeLocationAddressFaxNumber": "410-721-1207",
"EnumerationDate": "09/22/2008",
"LastUpdateDate": "04/18/2017",
"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": "363A00000X",
"TaxonomyName": "Physician Assistant",
"LicenseNumber": "C0005993",
"LicenseNumberStateCode": "MD",
"PrimaryTaxonomySwitch": "Y"
},
{
"TaxonomyCode": "363A00000X",
"TaxonomyName": "Physician Assistant",
"LicenseNumber": "0110003564",
"LicenseNumberStateCode": "VA",
"PrimaryTaxonomySwitch": "N"
}
]
},
"HealthcareProviderTaxonomyGroups": null
}
}