{
"Npi": {
"NPI": "1851563423",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "F. JEROME BURR, DDS, MDS, PLLC",
"LastName": null,
"FirstName": null,
"MiddleName": null,
"NamePrefix": null,
"NameSuffix": null,
"Credential": null,
"OtherOrgName": null,
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"OtherMiddleName": null,
"OtherNamePrefix": null,
"OtherNameSuffix": null,
"OtherCredential": null,
"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "1232 CAMP RAVINE RD",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "BURNS",
"MailingAddressStateName": "TN",
"MailingAddressPostalCode": "37029-5259",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "615-218-7770",
"MailingAddressFaxNumber": "615-446-6094",
"FirstLinePracticeLocationAddress": "314 E COLLEGE ST",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "DICKSON",
"PracticeLocationAddressStateName": "TN",
"PracticeLocationAddressPostalCode": "37055-1832",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "615-446-6041",
"PracticeLocationAddressFaxNumber": "615-446-6094",
"EnumerationDate": "03/24/2008",
"LastUpdateDate": "03/24/2008",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "BURR",
"AuthorizedOfficialFirstName": "FREDERICK",
"AuthorizedOfficialMiddleName": "JEROME",
"AuthorizedOfficialTitle": "ORTHODONTIST",
"AuthorizedOfficialNamePrefix": "DR.",
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "D.D.S., M.D.S.",
"AuthorizedOfficialTelephoneNumber": "615-390-1002",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "1223X0400X",
"TaxonomyName": "Orthodontics and Dentofacial Orthopedics Dentistry",
"LicenseNumber": "8270",
"LicenseNumberStateCode": "TN",
"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."
}
}
}
}