{
"Npi": {
"NPI": "1760674345",
"EntityType": "Individual",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": "N",
"IsOrgSubpart": null,
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": null,
"LastName": "GURRALA",
"FirstName": "JOSEPH",
"MiddleName": "PARIMAL",
"NamePrefix": "DR.",
"NameSuffix": null,
"Credential": "MD",
"OtherOrgName": null,
"OtherOrgNameTypeCode": null,
"OtherLastName": null,
"OtherFirstName": null,
"OtherMiddleName": null,
"OtherNamePrefix": null,
"OtherNameSuffix": null,
"OtherCredential": null,
"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "43280 MITCHAM SQ",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "ASHBURN",
"MailingAddressStateName": "VA",
"MailingAddressPostalCode": "20148-7039",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "571-230-4831",
"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "1043 STERLING RD STE 104",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "HERNDON",
"PracticeLocationAddressStateName": "VA",
"PracticeLocationAddressPostalCode": "20170-3842",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "703-743-7849",
"PracticeLocationAddressFaxNumber": null,
"EnumerationDate": "08/16/2007",
"LastUpdateDate": "01/13/2025",
"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": "208D00000X",
"TaxonomyName": "General Practice Physician",
"LicenseNumber": "0101242248",
"LicenseNumberStateCode": "VA",
"PrimaryTaxonomySwitch": "Y"
},
{
"TaxonomyCode": "207Q00000X",
"TaxonomyName": "Family Medicine Physician",
"LicenseNumber": "0101242248",
"LicenseNumberStateCode": "VA",
"PrimaryTaxonomySwitch": "N"
}
]
},
"HealthcareProviderTaxonomyGroups": null
}
}