{
"Npi": {
"NPI": "1922535830",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "JEMAAR GRAHAM DPM PA",
"LastName": null,
"FirstName": null,
"MiddleName": null,
"NamePrefix": null,
"NameSuffix": null,
"Credential": null,
"OtherOrgName": null,
"OtherOrgNameTypeCode": "6",
"OtherLastName": null,
"OtherFirstName": null,
"OtherMiddleName": null,
"OtherNamePrefix": null,
"OtherNameSuffix": null,
"OtherCredential": null,
"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "12839 GRAND BANK LN",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "ORLANDO",
"MailingAddressStateName": "FL",
"MailingAddressPostalCode": "32825-2737",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": null,
"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "12839 GRAND BANK LN",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "ORLANDO",
"PracticeLocationAddressStateName": "FL",
"PracticeLocationAddressPostalCode": "32825-2737",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "863-398-6309",
"PracticeLocationAddressFaxNumber": null,
"EnumerationDate": "05/23/2017",
"LastUpdateDate": "05/23/2017",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "GRAHAM",
"AuthorizedOfficialFirstName": "JEMAAR",
"AuthorizedOfficialMiddleName": "LEKEI",
"AuthorizedOfficialTitle": "CHIEF EXECUTIVE OFFICIER",
"AuthorizedOfficialNamePrefix": "DR.",
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "DPM",
"AuthorizedOfficialTelephoneNumber": "863-398-6309",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "261QP1100X",
"TaxonomyName": "Podiatric Clinic/Center",
"LicenseNumber": "PO3096",
"LicenseNumberStateCode": "FL",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}