{
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"FirstLineMailingAddress": "1021 NATIONAL RD",
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"MailingAddressStateName": "WV",
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"MailingAddressCountryCode": "US",
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"FirstLinePracticeLocationAddress": "1021 NATIONAL RD",
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"PracticeLocationAddressFaxNumber": null,
"EnumerationDate": "11/06/2006",
"LastUpdateDate": "08/05/2008",
"NPIDeactivationReasonCode": null,
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"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "BANNON",
"AuthorizedOfficialFirstName": "JOSEPH",
"AuthorizedOfficialMiddleName": "M.",
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"AuthorizedOfficialCredential": "O.D.",
"AuthorizedOfficialTelephoneNumber": "304-234-4455",
"Taxonomies": {
"Taxonomy": [
{
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},
{
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}
]
},
"HealthcareProviderTaxonomyGroups": {
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{
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},
{
"HealthcareProviderTaxonomyGroupName": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
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}
]
}
}
}