{
"Npi": {
"NPI": "1043697923",
"EntityType": "Individual",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": "N",
"IsOrgSubpart": null,
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": null,
"LastName": "NESTOR",
"FirstName": "COURTNEY",
"MiddleName": "ANNE",
"NamePrefix": null,
"NameSuffix": null,
"Credential": "MS, AT, ATC",
"OtherOrgName": null,
"OtherOrgNameTypeCode": null,
"OtherLastName": null,
"OtherFirstName": null,
"OtherMiddleName": null,
"OtherNamePrefix": null,
"OtherNameSuffix": null,
"OtherCredential": null,
"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "637 CLAYTON AVE NW",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "WALKER",
"MailingAddressStateName": "MI",
"MailingAddressPostalCode": "49534-3511",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "313-452-1023",
"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "11301 COMMERCE DR STE B",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "ALLENDALE",
"PracticeLocationAddressStateName": "MI",
"PracticeLocationAddressPostalCode": "49401-8200",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "616-895-4770",
"PracticeLocationAddressFaxNumber": null,
"EnumerationDate": "04/30/2015",
"LastUpdateDate": "02/15/2022",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": "F",
"Gender": "Female",
"AuthorizedOfficialLastName": null,
"AuthorizedOfficialFirstName": null,
"AuthorizedOfficialMiddleName": null,
"AuthorizedOfficialTitle": null,
"AuthorizedOfficialNamePrefix": null,
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": null,
"AuthorizedOfficialTelephoneNumber": null,
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "2255A2300X",
"TaxonomyName": "Athletic Trainer",
"LicenseNumber": "2601001658",
"LicenseNumberStateCode": "MI",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}