{
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"EIN": null,
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"OrgName": "SANDRA THOMAS",
"LastName": null,
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"MiddleName": null,
"NamePrefix": null,
"NameSuffix": null,
"Credential": null,
"OtherOrgName": null,
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"OtherCredential": null,
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"FirstLineMailingAddress": "6021 CHANNEL 16 WAY",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "JACKSON",
"MailingAddressStateName": "MS",
"MailingAddressPostalCode": "39209-9676",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "601-672-7835",
"MailingAddressFaxNumber": "601-346-7133",
"FirstLinePracticeLocationAddress": "6021 CHANNEL 16 WAY",
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"PracticeLocationAddressCityName": "JACKSON",
"PracticeLocationAddressStateName": "MS",
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"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "601-672-7835",
"PracticeLocationAddressFaxNumber": "601-346-7133",
"EnumerationDate": "10/10/2008",
"LastUpdateDate": "10/10/2008",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "THOMAS",
"AuthorizedOfficialFirstName": "SANDRA",
"AuthorizedOfficialMiddleName": "F.",
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"AuthorizedOfficialNamePrefix": "MRS.",
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"AuthorizedOfficialCredential": "CNS",
"AuthorizedOfficialTelephoneNumber": "601-672-7835",
"Taxonomies": {
"Taxonomy": {
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"TaxonomyName": "Nurse Practitioner",
"LicenseNumber": "R772161",
"LicenseNumberStateCode": "MS",
"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."
}
}
}
}