{
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"FirstLineMailingAddress": "1000 NORTH 18TH STREET",
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"MailingAddressStateName": "IN",
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"FirstLinePracticeLocationAddress": "1000 NORTH 18TH STREET",
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"EnumerationDate": "09/29/2006",
"LastUpdateDate": "08/22/2020",
"NPIDeactivationReasonCode": null,
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"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "WILSON",
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"TaxonomyName": "End-Stage Renal Disease (ESRD) Treatment Clinic/Center",
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}
},
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}
}