{
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"FirstLineMailingAddress": "11531 DAVENTRY DR NW",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "PICKERINGTON",
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"MailingAddressPostalCode": "43147-7525",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "614-459-6765",
"MailingAddressFaxNumber": "614-559-9927",
"FirstLinePracticeLocationAddress": "11531 DAVENTRY DR NW",
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"PracticeLocationAddressCityName": "PICKERINGTON",
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"PracticeLocationAddressTelephoneNumber": "614-459-6765",
"PracticeLocationAddressFaxNumber": "614-559-9927",
"EnumerationDate": "11/18/2021",
"LastUpdateDate": "11/18/2021",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "ADOMA",
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"AuthorizedOfficialCredential": "BSN,RN",
"AuthorizedOfficialTelephoneNumber": "614-596-7656",
"Taxonomies": {
"Taxonomy": {
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"TaxonomyName": "Home Health Agency",
"LicenseNumber": null,
"LicenseNumberStateCode": null,
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}