{
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"FirstLineMailingAddress": "1900 ROUTE 31",
"SecondLineMailingAddress": "SUITE 12",
"MailingAddressCityName": "MACEDON",
"MailingAddressStateName": "NY",
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"FirstLinePracticeLocationAddress": "1900 ROUTE 31",
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"EnumerationDate": "09/03/2015",
"LastUpdateDate": "09/03/2015",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "BESLEY",
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"AuthorizedOfficialCredential": "CPC",
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"Taxonomies": {
"Taxonomy": {
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"TaxonomyName": "Sports Physical Therapist",
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"LicenseNumberStateCode": "NY",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": {
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"HealthcareProviderTaxonomyGroupDescription": "Single Specialty Group - A business group of one or more individual practitioners, all of who practice with the same area of specialization."
}
}
}
}