{
"Npi": {
"NPI": "1740208859",
"EntityType": "Individual",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": "N",
"IsOrgSubpart": null,
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": null,
"LastName": "WARNER",
"FirstName": "CARLEEN",
"MiddleName": "TALBOT",
"NamePrefix": "DR.",
"NameSuffix": null,
"Credential": "MD",
"OtherOrgName": null,
"OtherOrgNameTypeCode": null,
"OtherLastName": "TALBOT",
"OtherFirstName": "CARLEEN",
"OtherMiddleName": "DONELLE",
"OtherNamePrefix": "MS.",
"OtherNameSuffix": null,
"OtherCredential": null,
"OtherLastNameTypeCode": "1",
"FirstLineMailingAddress": "PO BOX 746722",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "ATLANTA",
"MailingAddressStateName": "GA",
"MailingAddressPostalCode": "30374-6722",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "312-733-9730",
"MailingAddressFaxNumber": "312-929-0373",
"FirstLinePracticeLocationAddress": "1113 CARLISLE RD",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "YORK",
"PracticeLocationAddressStateName": "PA",
"PracticeLocationAddressPostalCode": "17404-4939",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "717-200-1567",
"PracticeLocationAddressFaxNumber": "717-674-6145",
"EnumerationDate": "07/17/2006",
"LastUpdateDate": "06/26/2024",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": "F",
"Gender": "Female",
"AuthorizedOfficialLastName": null,
"AuthorizedOfficialFirstName": null,
"AuthorizedOfficialMiddleName": null,
"AuthorizedOfficialTitle": null,
"AuthorizedOfficialNamePrefix": null,
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": null,
"AuthorizedOfficialTelephoneNumber": null,
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "207Q00000X",
"TaxonomyName": "Family Medicine Physician",
"LicenseNumber": "MD422909",
"LicenseNumberStateCode": "PA",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}