{
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"IsOrgSubpart": "N",
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"LastName": null,
"FirstName": null,
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"FirstLineMailingAddress": "9682 WAGNER CREEK RD",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "TALENT",
"MailingAddressStateName": "OR",
"MailingAddressPostalCode": "97540-7802",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": null,
"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "518 WASHINGTON ST",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "ASHLAND",
"PracticeLocationAddressStateName": "OR",
"PracticeLocationAddressPostalCode": "97520-1682",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "541-482-2021",
"PracticeLocationAddressFaxNumber": null,
"EnumerationDate": "12/21/2018",
"LastUpdateDate": "03/05/2019",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "HART-MARCH",
"AuthorizedOfficialFirstName": "TIMBER",
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"AuthorizedOfficialTitle": "OWNER",
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"AuthorizedOfficialCredential": null,
"AuthorizedOfficialTelephoneNumber": "541-951-6416",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "261Q00000X",
"TaxonomyName": "Clinic/Center",
"LicenseNumber": null,
"LicenseNumberStateCode": null,
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}