{
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"FirstLineMailingAddress": "9217 CLERKENWELL DR",
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"MailingAddressCityName": "WAXHAW",
"MailingAddressStateName": "NC",
"MailingAddressPostalCode": "28173-6788",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "901-834-6271",
"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "8000 CORPORATE CENTER DR STE 212",
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"PracticeLocationAddressCityName": "CHARLOTTE",
"PracticeLocationAddressStateName": "NC",
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"EnumerationDate": "07/23/2018",
"LastUpdateDate": "07/23/2018",
"NPIDeactivationReasonCode": null,
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"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
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"AuthorizedOfficialLastName": "NEWBY-BOYD",
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"AuthorizedOfficialCredential": "MD",
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"PrimaryTaxonomySwitch": "Y"
}
},
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}
}