{
"Npi": {
"NPI": "1649281726",
"EntityType": "Individual",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": "N",
"IsOrgSubpart": null,
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": null,
"LastName": "PETRY",
"FirstName": "MARCELLE",
"MiddleName": null,
"NamePrefix": "DR.",
"NameSuffix": null,
"Credential": "DC",
"OtherOrgName": null,
"OtherOrgNameTypeCode": null,
"OtherLastName": null,
"OtherFirstName": null,
"OtherMiddleName": null,
"OtherNamePrefix": null,
"OtherNameSuffix": null,
"OtherCredential": null,
"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "314 MESQUITE HILL DR",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "ARLINGTON",
"MailingAddressStateName": "TX",
"MailingAddressPostalCode": "76002-4478",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "817-539-0044",
"MailingAddressFaxNumber": "817-539-0682",
"FirstLinePracticeLocationAddress": "2400 HIGHWAY 287 N",
"SecondLinePracticeLocationAddress": "SUITE 104",
"PracticeLocationAddressCityName": "MANSFIELD",
"PracticeLocationAddressStateName": "TX",
"PracticeLocationAddressPostalCode": "76063-4828",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "817-539-0044",
"PracticeLocationAddressFaxNumber": "817-539-0682",
"EnumerationDate": "08/11/2006",
"LastUpdateDate": "07/08/2013",
"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": "111N00000X",
"TaxonomyName": "Chiropractor",
"LicenseNumber": "9680",
"LicenseNumberStateCode": "TX",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}