{
"Npi": {
"NPI": "1558727925",
"EntityType": "Individual",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": "N",
"IsOrgSubpart": null,
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": null,
"LastName": "CHORNEY",
"FirstName": "MARISA",
"MiddleName": "ELISE - GUERETTE",
"NamePrefix": "MRS.",
"NameSuffix": null,
"Credential": "FNP-BC",
"OtherOrgName": null,
"OtherOrgNameTypeCode": null,
"OtherLastName": null,
"OtherFirstName": null,
"OtherMiddleName": null,
"OtherNamePrefix": null,
"OtherNameSuffix": null,
"OtherCredential": null,
"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "PO BOX 1705",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "AUGUSTA",
"MailingAddressStateName": "GA",
"MailingAddressPostalCode": "30903-1705",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "706-854-6008",
"MailingAddressFaxNumber": "706-774-7230",
"FirstLinePracticeLocationAddress": "3486 PEACH ORCHARD RD STE 200",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "AUGUSTA",
"PracticeLocationAddressStateName": "GA",
"PracticeLocationAddressPostalCode": "30906-5215",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "706-828-8049",
"PracticeLocationAddressFaxNumber": null,
"EnumerationDate": "01/14/2016",
"LastUpdateDate": "03/11/2021",
"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": "363LF0000X",
"TaxonomyName": "Family Nurse Practitioner",
"LicenseNumber": "0024173184",
"LicenseNumberStateCode": "VA",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}