{
"Npi": {
"NPI": "1700106549",
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"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "SHIROLYN MOFFETT M.D.,P.A.",
"LastName": null,
"FirstName": null,
"MiddleName": null,
"NamePrefix": null,
"NameSuffix": null,
"Credential": null,
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"OtherOrgNameTypeCode": null,
"OtherLastName": null,
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"OtherMiddleName": null,
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"OtherCredential": null,
"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "715 W SHERMAN AVE",
"SecondLineMailingAddress": "SUITE D",
"MailingAddressCityName": "HARRISON",
"MailingAddressStateName": "AR",
"MailingAddressPostalCode": "72601-2743",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "870-204-5129",
"MailingAddressFaxNumber": "870-204-5131",
"FirstLinePracticeLocationAddress": "715 W SHERMAN AVE",
"SecondLinePracticeLocationAddress": "SUITE D",
"PracticeLocationAddressCityName": "HARRISON",
"PracticeLocationAddressStateName": "AR",
"PracticeLocationAddressPostalCode": "72601-2743",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "870-204-5129",
"PracticeLocationAddressFaxNumber": "870-204-5131",
"EnumerationDate": "06/03/2010",
"LastUpdateDate": "06/03/2010",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "MOFFETT",
"AuthorizedOfficialFirstName": "SHIROLYN",
"AuthorizedOfficialMiddleName": "RUTH",
"AuthorizedOfficialTitle": "PRESIDENT",
"AuthorizedOfficialNamePrefix": "DR.",
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "M.D.",
"AuthorizedOfficialTelephoneNumber": "870-204-5129",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "207QA0505X",
"TaxonomyName": "Adult Medicine Physician",
"LicenseNumber": "E0693",
"LicenseNumberStateCode": "AR",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": {
"HealthcareProviderTaxonomyGroup": {
"HealthcareProviderTaxonomyGroupName": "193400000X SINGLE SPECIALTY GROUP",
"HealthcareProviderTaxonomyGroupDescription": "Single Specialty Group - A business group of one or more individual practitioners, all of who practice with the same area of specialization."
}
}
}
}