{
"Npi": {
"NPI": "1942259460",
"EntityType": "Individual",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": "N",
"IsOrgSubpart": null,
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": null,
"LastName": "COLONY",
"FirstName": "MARY",
"MiddleName": "DEBORAH",
"NamePrefix": "DR.",
"NameSuffix": null,
"Credential": "M.D.,ABEM,RDMS",
"OtherOrgName": null,
"OtherOrgNameTypeCode": null,
"OtherLastName": null,
"OtherFirstName": null,
"OtherMiddleName": null,
"OtherNamePrefix": null,
"OtherNameSuffix": null,
"OtherCredential": null,
"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "1100 MILL POND RD",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "FABER",
"MailingAddressStateName": "VA",
"MailingAddressPostalCode": "22938-2776",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "917-841-1355",
"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "1073 FATHER JUDGE RD",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "MONROE",
"PracticeLocationAddressStateName": "VA",
"PracticeLocationAddressPostalCode": "24574-2771",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "434-929-8507",
"PracticeLocationAddressFaxNumber": "434-929-8490",
"EnumerationDate": "05/10/2006",
"LastUpdateDate": "10/30/2025",
"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": "207P00000X",
"TaxonomyName": "Emergency Medicine Physician",
"LicenseNumber": "0101269680",
"LicenseNumberStateCode": "VA",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}