{
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"FirstLineMailingAddress": "1365 ROCK QUARRY RD",
"SecondLineMailingAddress": "SUITE 202",
"MailingAddressCityName": "STOCKBRIDGE",
"MailingAddressStateName": "GA",
"MailingAddressPostalCode": "30281-5029",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "770-771-6580",
"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "6300 HOSPITAL PKWY",
"SecondLinePracticeLocationAddress": "SUITE 425",
"PracticeLocationAddressCityName": "JOHNS CREEK",
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"EnumerationDate": "04/19/2017",
"LastUpdateDate": "08/25/2017",
"NPIDeactivationReasonCode": null,
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"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "MATHES",
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"AuthorizedOfficialTelephoneNumber": "770-771-6582",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "261QA1903X",
"TaxonomyName": "Ambulatory Surgical Clinic/Center",
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"PrimaryTaxonomySwitch": "Y"
}
},
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}
}