{
"Npi": {
"NPI": "1982994604",
"EntityType": "Individual",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": "N",
"IsOrgSubpart": null,
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": null,
"LastName": "BAO",
"FirstName": "XIAOHONG",
"MiddleName": null,
"NamePrefix": "MR.",
"NameSuffix": null,
"Credential": null,
"OtherOrgName": null,
"OtherOrgNameTypeCode": null,
"OtherLastName": "BAO",
"OtherFirstName": "KEVIN",
"OtherMiddleName": null,
"OtherNamePrefix": null,
"OtherNameSuffix": null,
"OtherCredential": null,
"OtherLastNameTypeCode": "5",
"FirstLineMailingAddress": "2523 WILLOWLAWN ST",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "ROANOKE",
"MailingAddressStateName": "VA",
"MailingAddressPostalCode": "24018-2526",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "540-989-1390",
"MailingAddressFaxNumber": "540-989-1390",
"FirstLinePracticeLocationAddress": "140 MAIN STREET",
"SecondLinePracticeLocationAddress": "RITE AID PHARMACY",
"PracticeLocationAddressCityName": "STUART",
"PracticeLocationAddressStateName": "VA",
"PracticeLocationAddressPostalCode": "24171",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "276-694-4034",
"PracticeLocationAddressFaxNumber": null,
"EnumerationDate": "04/14/2011",
"LastUpdateDate": "04/14/2011",
"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": "183500000X",
"TaxonomyName": "Pharmacist",
"LicenseNumber": "0202012832",
"LicenseNumberStateCode": "VA",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}