{
"Npi": {
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"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "PATRICK EDWARD GILLILAND, LLC",
"LastName": null,
"FirstName": null,
"MiddleName": null,
"NamePrefix": null,
"NameSuffix": null,
"Credential": null,
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"OtherCredential": null,
"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "9635 VENTANA WAY",
"SecondLineMailingAddress": "SUITE 101",
"MailingAddressCityName": "JOHNS CREEK",
"MailingAddressStateName": "GA",
"MailingAddressPostalCode": "30022-8620",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "678-366-8862",
"MailingAddressFaxNumber": "678-739-0119",
"FirstLinePracticeLocationAddress": "9635 VENTANA WAY",
"SecondLinePracticeLocationAddress": "SUITE 101",
"PracticeLocationAddressCityName": "JOHNS CREEK",
"PracticeLocationAddressStateName": "GA",
"PracticeLocationAddressPostalCode": "30022-8620",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "678-366-8862",
"PracticeLocationAddressFaxNumber": "678-739-0119",
"EnumerationDate": "02/18/2014",
"LastUpdateDate": "02/18/2014",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "GILLILAND",
"AuthorizedOfficialFirstName": "PATRICK",
"AuthorizedOfficialMiddleName": "EDWARD",
"AuthorizedOfficialTitle": "MARRIAGE AND FAMILY THERAPIST",
"AuthorizedOfficialNamePrefix": "MR.",
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "LMFT",
"AuthorizedOfficialTelephoneNumber": "602-463-5673",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "106H00000X",
"TaxonomyName": "Marriage & Family Therapist",
"LicenseNumber": "MFT001143",
"LicenseNumberStateCode": "GA",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": {
"HealthcareProviderTaxonomyGroup": {
"HealthcareProviderTaxonomyGroupName": "193400000X SINGLE SPECIALTY GROUP",
"HealthcareProviderTaxonomyGroupDescription": "Single Specialty Group - A business group of one or more individual practitioners, all of who practice with the same area of specialization."
}
}
}
}