{
"Npi": {
"NPI": "1083484018",
"EntityType": "Individual",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": "Y",
"IsOrgSubpart": null,
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": null,
"LastName": "NICHOLS",
"FirstName": "LYDIA",
"MiddleName": "MARIA",
"NamePrefix": "MS.",
"NameSuffix": null,
"Credential": "INDEPENDENT PROVIDER",
"OtherOrgName": null,
"OtherOrgNameTypeCode": null,
"OtherLastName": "NICHOLS",
"OtherFirstName": "LYDIA",
"OtherMiddleName": "MARIA",
"OtherNamePrefix": "MS.",
"OtherNameSuffix": null,
"OtherCredential": null,
"OtherLastNameTypeCode": "2",
"FirstLineMailingAddress": "4730 MASSILLON RD",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "NORTH CANTON",
"MailingAddressStateName": "OH",
"MailingAddressPostalCode": "44720-1166",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "330-906-1480",
"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "4730 MASSILLON RD",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "NORTH CANTON",
"PracticeLocationAddressStateName": "OH",
"PracticeLocationAddressPostalCode": "44720-1166",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "330-906-1480",
"PracticeLocationAddressFaxNumber": null,
"EnumerationDate": "01/02/2024",
"LastUpdateDate": "03/01/2024",
"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": "253Z00000X",
"TaxonomyName": "In Home Supportive Care Agency",
"LicenseNumber": null,
"LicenseNumberStateCode": null,
"PrimaryTaxonomySwitch": "N"
},
{
"TaxonomyCode": "172A00000X",
"TaxonomyName": "Driver",
"LicenseNumber": null,
"LicenseNumberStateCode": null,
"PrimaryTaxonomySwitch": "N"
},
{
"TaxonomyCode": "376J00000X",
"TaxonomyName": "Homemaker",
"LicenseNumber": null,
"LicenseNumberStateCode": null,
"PrimaryTaxonomySwitch": "Y"
}
]
},
"HealthcareProviderTaxonomyGroups": null
}
}