1083974091 NPI number — PHAEDRA MCLAUGHLIN PMP, CPC, PAHM, CPHT

NPI Number: 1083974091
Health Care Provider/Practitioner: PHAEDRA MCLAUGHLIN PMP, CPC, PAHM, CPHT

NPI Number : 1083974091 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1083974091",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "Y",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "MCLAUGHLIN",
    "FirstName": "PHAEDRA",
    "MiddleName": null,
    "NamePrefix": "MS.",
    "NameSuffix": null,
    "Credential": "PMP, CPC, PAHM, CPHT",
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": null,
    "OtherFirstName": null,
    "OtherMiddleName": null,
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": null,
    "FirstLineMailingAddress": "407 GREENS RD",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "HOUSTON",
    "MailingAddressStateName": "TX",
    "MailingAddressPostalCode": "77060-2118",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "346-885-1883",
    "MailingAddressFaxNumber": null,
    "FirstLinePracticeLocationAddress": "407 GREENS RD",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "HOUSTON",
    "PracticeLocationAddressStateName": "TX",
    "PracticeLocationAddressPostalCode": "77060-2118",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "346-885-1883",
    "PracticeLocationAddressFaxNumber": null,
    "EnumerationDate": "05/23/2012",
    "LastUpdateDate": "12/10/2025",
    "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": "183700000X",
          "TaxonomyName": "Pharmacy Technician",
          "LicenseNumber": "23878441",
          "LicenseNumberStateCode": "WI",
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "183700000X",
          "TaxonomyName": "Pharmacy Technician",
          "LicenseNumber": "0019458",
          "LicenseNumberStateCode": "CO",
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "183700000X",
          "TaxonomyName": "Pharmacy Technician",
          "LicenseNumber": "37723",
          "LicenseNumberStateCode": "NC",
          "PrimaryTaxonomySwitch": "Y"
        },
        {
          "TaxonomyCode": "183700000X",
          "TaxonomyName": "Pharmacy Technician",
          "LicenseNumber": "0230023306",
          "LicenseNumberStateCode": "VA",
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "183700000X",
          "TaxonomyName": "Pharmacy Technician",
          "LicenseNumber": "049283791",
          "LicenseNumberStateCode": "IL",
          "PrimaryTaxonomySwitch": "N"
        }
      ]
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}