{
"Npi": {
"NPI": "1851830178",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "PATRONUS PHYSICIANS GROUP PC",
"LastName": null,
"FirstName": null,
"MiddleName": null,
"NamePrefix": null,
"NameSuffix": null,
"Credential": null,
"OtherOrgName": null,
"OtherOrgNameTypeCode": null,
"OtherLastName": null,
"OtherFirstName": null,
"OtherMiddleName": null,
"OtherNamePrefix": null,
"OtherNameSuffix": null,
"OtherCredential": null,
"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "8000 TOWERS CRESCENT DR",
"SecondLineMailingAddress": "SUITE 1350",
"MailingAddressCityName": "VIENNA",
"MailingAddressStateName": "VA",
"MailingAddressPostalCode": "22182-6207",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "866-450-1918",
"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "8000 TOWERS CRESCENT DR",
"SecondLinePracticeLocationAddress": "SUITE 1350",
"PracticeLocationAddressCityName": "VIENNA",
"PracticeLocationAddressStateName": "VA",
"PracticeLocationAddressPostalCode": "22182-6207",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "866-450-1918",
"PracticeLocationAddressFaxNumber": null,
"EnumerationDate": "02/20/2017",
"LastUpdateDate": "02/20/2017",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "GRAINGER",
"AuthorizedOfficialFirstName": "CAREY",
"AuthorizedOfficialMiddleName": null,
"AuthorizedOfficialTitle": "CEO",
"AuthorizedOfficialNamePrefix": null,
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": null,
"AuthorizedOfficialTelephoneNumber": "404-822-4823",
"Taxonomies": {
"Taxonomy": [
{
"TaxonomyCode": "2084V0102X",
"TaxonomyName": "Vascular Neurology Physician",
"LicenseNumber": null,
"LicenseNumberStateCode": null,
"PrimaryTaxonomySwitch": "N"
},
{
"TaxonomyCode": "208D00000X",
"TaxonomyName": "General Practice Physician",
"LicenseNumber": null,
"LicenseNumberStateCode": null,
"PrimaryTaxonomySwitch": "Y"
}
]
},
"HealthcareProviderTaxonomyGroups": {
"HealthcareProviderTaxonomyGroup": [
{
"HealthcareProviderTaxonomyGroupName": "193200000X MULTI-SPECIALTY GROUP",
"HealthcareProviderTaxonomyGroupDescription": "Multi-Specialty Group - A business group of one or more individual practitioners, who practice with different areas of specialization."
},
{
"HealthcareProviderTaxonomyGroupName": "193200000X MULTI-SPECIALTY GROUP",
"HealthcareProviderTaxonomyGroupDescription": "Multi-Specialty Group - A business group of one or more individual practitioners, who practice with different areas of specialization."
}
]
}
}
}