{
"Npi": {
"NPI": "1063858710",
"EntityType": "Individual",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": "N",
"IsOrgSubpart": null,
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": null,
"LastName": "BLAIR-STURTEVANT",
"FirstName": "DEMORIE",
"MiddleName": "RAEANNA",
"NamePrefix": "DR.",
"NameSuffix": null,
"Credential": "D.C.",
"OtherOrgName": null,
"OtherOrgNameTypeCode": null,
"OtherLastName": "BLAIR",
"OtherFirstName": "DEMORIE",
"OtherMiddleName": "RAEANNA",
"OtherNamePrefix": "DR.",
"OtherNameSuffix": null,
"OtherCredential": "D.C.",
"OtherLastNameTypeCode": "1",
"FirstLineMailingAddress": "PO BOX 132",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "MILLEDGEVILLE",
"MailingAddressStateName": "IL",
"MailingAddressPostalCode": "61051-0132",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "815-855-3061",
"MailingAddressFaxNumber": "815-855-3062",
"FirstLinePracticeLocationAddress": "444 N MAIN AVE",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "MILLEDGEVILLE",
"PracticeLocationAddressStateName": "IL",
"PracticeLocationAddressPostalCode": "61051-9506",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "815-855-3061",
"PracticeLocationAddressFaxNumber": "815-855-3062",
"EnumerationDate": "05/21/2013",
"LastUpdateDate": "01/09/2018",
"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": "111N00000X",
"TaxonomyName": "Chiropractor",
"LicenseNumber": "038.012432",
"LicenseNumberStateCode": "IL",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}