{
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"NamePrefix": null,
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"FirstLineMailingAddress": "1011 COPPER STONE CIR",
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"MailingAddressStateName": "VA",
"MailingAddressPostalCode": "23320-8274",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "757-617-3398",
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"FirstLinePracticeLocationAddress": "1020 INDEPENDENCE BLVD",
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"EnumerationDate": "08/22/2007",
"LastUpdateDate": "02/12/2008",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "DIGERONIMO",
"AuthorizedOfficialFirstName": "DREW",
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"AuthorizedOfficialCredential": "BBA,RDCS",
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"Taxonomies": {
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"TaxonomyName": "Clinic/Center",
"LicenseNumber": null,
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"PrimaryTaxonomySwitch": "Y"
}
},
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}
}