{
"Npi": {
"NPI": "1649489014",
"EntityType": "Individual",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": "N",
"IsOrgSubpart": null,
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": null,
"LastName": "BALLARD",
"FirstName": "ARTHUR",
"MiddleName": "R",
"NamePrefix": "DR.",
"NameSuffix": "II",
"Credential": "MD",
"OtherOrgName": null,
"OtherOrgNameTypeCode": null,
"OtherLastName": "BALLARD",
"OtherFirstName": "ARTHUR",
"OtherMiddleName": "R",
"OtherNamePrefix": "DR.",
"OtherNameSuffix": "II",
"OtherCredential": "MD",
"OtherLastNameTypeCode": "2",
"FirstLineMailingAddress": "23081 HARBORVIEW RD",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "PORT CHARLOTTE",
"MailingAddressStateName": "FL",
"MailingAddressPostalCode": "33980-2153",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "941-235-8762",
"MailingAddressFaxNumber": "941-237-5691",
"FirstLinePracticeLocationAddress": "23081 HARBORVIEW RD",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "PORT CHARLOTTE",
"PracticeLocationAddressStateName": "FL",
"PracticeLocationAddressPostalCode": "33980-2153",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "941-235-8762",
"PracticeLocationAddressFaxNumber": "941-237-5691",
"EnumerationDate": "05/22/2007",
"LastUpdateDate": "07/21/2022",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": "M",
"Gender": "Male",
"AuthorizedOfficialLastName": null,
"AuthorizedOfficialFirstName": null,
"AuthorizedOfficialMiddleName": null,
"AuthorizedOfficialTitle": null,
"AuthorizedOfficialNamePrefix": null,
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": null,
"AuthorizedOfficialTelephoneNumber": null,
"Taxonomies": {
"Taxonomy": [
{
"TaxonomyCode": "207R00000X",
"TaxonomyName": "Internal Medicine Physician",
"LicenseNumber": "MT188710",
"LicenseNumberStateCode": "PA",
"PrimaryTaxonomySwitch": "N"
},
{
"TaxonomyCode": "2085R0202X",
"TaxonomyName": "Diagnostic Radiology Physician",
"LicenseNumber": "D76695",
"LicenseNumberStateCode": "MD",
"PrimaryTaxonomySwitch": "N"
},
{
"TaxonomyCode": "2085R0202X",
"TaxonomyName": "Diagnostic Radiology Physician",
"LicenseNumber": "35-097902",
"LicenseNumberStateCode": "OH",
"PrimaryTaxonomySwitch": "N"
},
{
"TaxonomyCode": "2085R0202X",
"TaxonomyName": "Diagnostic Radiology Physician",
"LicenseNumber": "ME112324",
"LicenseNumberStateCode": "FL",
"PrimaryTaxonomySwitch": "Y"
}
]
},
"HealthcareProviderTaxonomyGroups": null
}
}