{
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"FirstLineMailingAddress": "484 CHURCH RD.",
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"MailingAddressCountryCode": "US",
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"MailingAddressFaxNumber": "662-349-2828",
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"EnumerationDate": "07/01/2006",
"LastUpdateDate": "10/11/2012",
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"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "HELLUMS",
"AuthorizedOfficialFirstName": "SHAWN",
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"AuthorizedOfficialCredential": "O.D.",
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"Taxonomies": {
"Taxonomy": {
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"TaxonomyName": "Optometrist",
"LicenseNumber": null,
"LicenseNumberStateCode": null,
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": {
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}
}
}
}