{
"Npi": {
"NPI": "1043664329",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "SHARAT K. JAIN, PH.D. CLINICAL PSYCHOLOGIST",
"LastName": null,
"FirstName": null,
"MiddleName": null,
"NamePrefix": null,
"NameSuffix": null,
"Credential": null,
"OtherOrgName": null,
"OtherOrgNameTypeCode": null,
"OtherLastName": null,
"OtherFirstName": null,
"OtherMiddleName": null,
"OtherNamePrefix": null,
"OtherNameSuffix": null,
"OtherCredential": null,
"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "10705 RIVER RD",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "POTOMAC",
"MailingAddressStateName": "MD",
"MailingAddressPostalCode": "20854-4113",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "301-693-5513",
"MailingAddressFaxNumber": "301-765-3366",
"FirstLinePracticeLocationAddress": "3230 PENNSYLVANIA AVE SE",
"SecondLinePracticeLocationAddress": "SUITE 213",
"PracticeLocationAddressCityName": "WASHINGTON",
"PracticeLocationAddressStateName": "DC",
"PracticeLocationAddressPostalCode": "20020-3722",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "301-693-5513",
"PracticeLocationAddressFaxNumber": "301-765-3366",
"EnumerationDate": "04/22/2016",
"LastUpdateDate": "04/22/2016",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "JAIN",
"AuthorizedOfficialFirstName": "SHARAT",
"AuthorizedOfficialMiddleName": "K.",
"AuthorizedOfficialTitle": "CLINICAL PSYCHOLOGIST",
"AuthorizedOfficialNamePrefix": null,
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "PH.D.",
"AuthorizedOfficialTelephoneNumber": "301-693-5513",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "103TC0700X",
"TaxonomyName": "Clinical Psychologist",
"LicenseNumber": "PSY1000064",
"LicenseNumberStateCode": "DC",
"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."
}
}
}
}