{
"Npi": {
"NPI": "1710206875",
"EntityType": "Individual",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": "N",
"IsOrgSubpart": null,
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": null,
"LastName": "MOORE",
"FirstName": "BRANDON",
"MiddleName": "JAY",
"NamePrefix": "MR.",
"NameSuffix": null,
"Credential": "APA-C",
"OtherOrgName": null,
"OtherOrgNameTypeCode": null,
"OtherLastName": null,
"OtherFirstName": null,
"OtherMiddleName": null,
"OtherNamePrefix": null,
"OtherNameSuffix": null,
"OtherCredential": null,
"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "1600 PENNSYLVANIA AVENUE",
"SecondLineMailingAddress": "WHITE HOUSE MEDICAL UNIT",
"MailingAddressCityName": "WASHINGTON",
"MailingAddressStateName": "DC",
"MailingAddressPostalCode": "20004-0000",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "202-757-2476",
"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "1600 PENNSYLVANIA AVE NW",
"SecondLinePracticeLocationAddress": "WHITE HOUSE MEDICAL UNIT",
"PracticeLocationAddressCityName": "WASHINGTON",
"PracticeLocationAddressStateName": "DC",
"PracticeLocationAddressPostalCode": "20500-0003",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "202-757-2476",
"PracticeLocationAddressFaxNumber": null,
"EnumerationDate": "05/27/2010",
"LastUpdateDate": "02/24/2017",
"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": "363A00000X",
"TaxonomyName": "Physician Assistant",
"LicenseNumber": null,
"LicenseNumberStateCode": null,
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}