{
"Npi": {
"NPI": "1932254356",
"EntityType": "Individual",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": "N",
"IsOrgSubpart": null,
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": null,
"LastName": "RODANTE",
"FirstName": "JUSTIN",
"MiddleName": null,
"NamePrefix": null,
"NameSuffix": null,
"Credential": "PAC",
"OtherOrgName": null,
"OtherOrgNameTypeCode": null,
"OtherLastName": null,
"OtherFirstName": null,
"OtherMiddleName": null,
"OtherNamePrefix": null,
"OtherNameSuffix": null,
"OtherCredential": null,
"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "10 CENTER DRIVE MSC 1476",
"SecondLineMailingAddress": "ROOM 5-3140",
"MailingAddressCityName": "BETHESDA",
"MailingAddressStateName": "MD",
"MailingAddressPostalCode": "20892-0001",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "301-827-6417",
"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "10 CENTER DRIVE BUILDING 10 CRC MSC 1476",
"SecondLinePracticeLocationAddress": "ROOM 5-3140",
"PracticeLocationAddressCityName": "BETHESDA",
"PracticeLocationAddressStateName": "MD",
"PracticeLocationAddressPostalCode": "20892-0001",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "301-827-6417",
"PracticeLocationAddressFaxNumber": null,
"EnumerationDate": "01/24/2007",
"LastUpdateDate": "05/31/2016",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": "M",
"Gender": "Male",
"AuthorizedOfficialLastName": null,
"AuthorizedOfficialFirstName": null,
"AuthorizedOfficialMiddleName": null,
"AuthorizedOfficialTitle": null,
"AuthorizedOfficialNamePrefix": null,
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": null,
"AuthorizedOfficialTelephoneNumber": null,
"Taxonomies": {
"Taxonomy": [
{
"TaxonomyCode": "363A00000X",
"TaxonomyName": "Physician Assistant",
"LicenseNumber": "PA30321",
"LicenseNumberStateCode": "DC",
"PrimaryTaxonomySwitch": "N"
},
{
"TaxonomyCode": "363AM0700X",
"TaxonomyName": "Medical Physician Assistant",
"LicenseNumber": "C05297",
"LicenseNumberStateCode": "MD",
"PrimaryTaxonomySwitch": "Y"
}
]
},
"HealthcareProviderTaxonomyGroups": null
}
}