{
"Npi": {
"NPI": "1083071807",
"EntityType": "Organization",
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"EIN": null,
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"IsOrgSubpart": "N",
"ParentOrgLBN": null,
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"OrgName": "TEGAN HINAMAN",
"LastName": null,
"FirstName": null,
"MiddleName": null,
"NamePrefix": null,
"NameSuffix": null,
"Credential": null,
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"OtherLastName": null,
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"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "302 KISKADEE LOOP",
"SecondLineMailingAddress": "UNIT A",
"MailingAddressCityName": "CONWAY",
"MailingAddressStateName": "SC",
"MailingAddressPostalCode": "29526-9771",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "570-447-3010",
"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "302 KISKADEE LOOP",
"SecondLinePracticeLocationAddress": "UNIT A",
"PracticeLocationAddressCityName": "CONWAY",
"PracticeLocationAddressStateName": "SC",
"PracticeLocationAddressPostalCode": "29526-9771",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "570-447-3010",
"PracticeLocationAddressFaxNumber": null,
"EnumerationDate": "01/25/2016",
"LastUpdateDate": "01/25/2016",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "HINAMAN",
"AuthorizedOfficialFirstName": "TEGAN",
"AuthorizedOfficialMiddleName": "MARIE",
"AuthorizedOfficialTitle": "ATHLETIC TRAINER",
"AuthorizedOfficialNamePrefix": null,
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "MS ATC SCAT",
"AuthorizedOfficialTelephoneNumber": "570-447-3010",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "261QR0400X",
"TaxonomyName": "Rehabilitation Clinic/Center",
"LicenseNumber": "1530",
"LicenseNumberStateCode": "SC",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}