{
"Npi": {
"NPI": "1063524239",
"EntityType": "Individual",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": "N",
"IsOrgSubpart": null,
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": null,
"LastName": "SCORDO",
"FirstName": "KRISTINE",
"MiddleName": "A",
"NamePrefix": null,
"NameSuffix": null,
"Credential": "NP",
"OtherOrgName": null,
"OtherOrgNameTypeCode": null,
"OtherLastName": null,
"OtherFirstName": null,
"OtherMiddleName": null,
"OtherNamePrefix": null,
"OtherNameSuffix": null,
"OtherCredential": null,
"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "4000 MIAMISBURG CENTERVILLE RD",
"SecondLineMailingAddress": "SUITE 100",
"MailingAddressCityName": "MIAMISBURG",
"MailingAddressStateName": "OH",
"MailingAddressPostalCode": "45342-7615",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "937-643-9939",
"MailingAddressFaxNumber": "937-643-9949",
"FirstLinePracticeLocationAddress": "4000 MIAMISBURG CENTERVILLE RD",
"SecondLinePracticeLocationAddress": "SUITE 100",
"PracticeLocationAddressCityName": "MIAMISBURG",
"PracticeLocationAddressStateName": "OH",
"PracticeLocationAddressPostalCode": "45342-7615",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "937-643-9939",
"PracticeLocationAddressFaxNumber": "937-643-9949",
"EnumerationDate": "08/31/2006",
"LastUpdateDate": "05/11/2016",
"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": "363LA2100X",
"TaxonomyName": "Acute Care Nurse Practitioner",
"LicenseNumber": "RN146504",
"LicenseNumberStateCode": "OH",
"PrimaryTaxonomySwitch": "N"
},
{
"TaxonomyCode": "363LA2100X",
"TaxonomyName": "Acute Care Nurse Practitioner",
"LicenseNumber": "COA05877NP",
"LicenseNumberStateCode": "OH",
"PrimaryTaxonomySwitch": "Y"
}
]
},
"HealthcareProviderTaxonomyGroups": null
}
}