{
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"FirstLineMailingAddress": "2222 S 16TH ST",
"SecondLineMailingAddress": "SUITE 200",
"MailingAddressCityName": "LINCOLN",
"MailingAddressStateName": "NE",
"MailingAddressPostalCode": "68502-3796",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "402-475-9090",
"MailingAddressFaxNumber": "402-475-9092",
"FirstLinePracticeLocationAddress": "2222 S 16TH ST",
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"PracticeLocationAddressCityName": "LINCOLN",
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"PracticeLocationAddressTelephoneNumber": "402-475-9090",
"PracticeLocationAddressFaxNumber": "402-475-9092",
"EnumerationDate": "09/02/2010",
"LastUpdateDate": "09/02/2010",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "CODY",
"AuthorizedOfficialFirstName": "CAROLYN",
"AuthorizedOfficialMiddleName": "S",
"AuthorizedOfficialTitle": "MEMBER",
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"AuthorizedOfficialCredential": "M.D.",
"AuthorizedOfficialTelephoneNumber": "402-475-9090",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "173000000X",
"TaxonomyName": "Legal Medicine",
"LicenseNumber": "21626",
"LicenseNumberStateCode": "NE",
"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."
}
}
}
}