{
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"FirstLineMailingAddress": "109 S 13TH AVE",
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"PracticeLocationAddressFaxNumber": "989-340-0559",
"EnumerationDate": "01/14/2008",
"LastUpdateDate": "05/17/2019",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": "02/01/2010",
"NPIReactivationDate": "04/11/2018",
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"Gender": null,
"AuthorizedOfficialLastName": "DARGIS",
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"Taxonomies": {
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"TaxonomyName": "Family Medicine Physician",
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"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": {
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}
}
}
}