{
"Npi": {
"NPI": "1861306029",
"EntityType": "Individual",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": "Y",
"IsOrgSubpart": null,
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": null,
"LastName": "DUNDORF",
"FirstName": "ANNA",
"MiddleName": "LEE",
"NamePrefix": null,
"NameSuffix": null,
"Credential": null,
"OtherOrgName": null,
"OtherOrgNameTypeCode": null,
"OtherLastName": "NEDROW",
"OtherFirstName": "ANNA",
"OtherMiddleName": "LEE",
"OtherNamePrefix": null,
"OtherNameSuffix": null,
"OtherCredential": null,
"OtherLastNameTypeCode": "1",
"FirstLineMailingAddress": "270 MADDOX DR",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "ABERDEEN",
"MailingAddressStateName": "NC",
"MailingAddressPostalCode": "28315-5005",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "704-776-3190",
"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "155 MEMORIAL DR",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "PINEHURST",
"PracticeLocationAddressStateName": "NC",
"PracticeLocationAddressPostalCode": "28374-8710",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "910-715-1000",
"PracticeLocationAddressFaxNumber": null,
"EnumerationDate": "10/02/2026",
"LastUpdateDate": "10/02/2026",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": "F",
"Gender": "Female",
"AuthorizedOfficialLastName": null,
"AuthorizedOfficialFirstName": null,
"AuthorizedOfficialMiddleName": null,
"AuthorizedOfficialTitle": null,
"AuthorizedOfficialNamePrefix": null,
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": null,
"AuthorizedOfficialTelephoneNumber": null,
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "163WC0200X",
"TaxonomyName": "Critical Care Medicine Registered Nurse",
"LicenseNumber": "1110463",
"LicenseNumberStateCode": "TX",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}