{
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"OrgName": "SOUTH ATLANTA KIDNEY CARE",
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"FirstLineMailingAddress": "195 UPPER RIVERDALE RD",
"SecondLineMailingAddress": "SUITE A",
"MailingAddressCityName": "RIVERDALE",
"MailingAddressStateName": "GA",
"MailingAddressPostalCode": "30274",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "770-994-0171",
"MailingAddressFaxNumber": "770-507-4190",
"FirstLinePracticeLocationAddress": "2221 PEACHTREE RD NE",
"SecondLinePracticeLocationAddress": "SUITE D195",
"PracticeLocationAddressCityName": "ATLANTA",
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"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "770-994-0171",
"PracticeLocationAddressFaxNumber": "770-507-4190",
"EnumerationDate": "04/18/2007",
"LastUpdateDate": "06/24/2008",
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"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "BELIZAIRE",
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"AuthorizedOfficialTitle": "MEDICAL DIRECTOR",
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"AuthorizedOfficialTelephoneNumber": "770-994-0171",
"Taxonomies": {
"Taxonomy": {
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"TaxonomyName": "Nephrology Physician",
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"LicenseNumberStateCode": "GA",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": {
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}
}
}
}