{
"Npi": {
"NPI": "1114683810",
"EntityType": "Individual",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": "N",
"IsOrgSubpart": null,
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": null,
"LastName": "CUNNINGHAM",
"FirstName": "TARA",
"MiddleName": "B",
"NamePrefix": null,
"NameSuffix": null,
"Credential": "APRN",
"OtherOrgName": null,
"OtherOrgNameTypeCode": null,
"OtherLastName": null,
"OtherFirstName": null,
"OtherMiddleName": null,
"OtherNamePrefix": null,
"OtherNameSuffix": null,
"OtherCredential": null,
"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "1808 CARMEL DR",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "LAWRENCE",
"MailingAddressStateName": "KS",
"MailingAddressPostalCode": "66047-1852",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "207-350-2626",
"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "6265 ROCK CHALK DR STE 1500",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "LAWRENCE",
"PracticeLocationAddressStateName": "KS",
"PracticeLocationAddressPostalCode": "66049-5232",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "785-843-9125",
"PracticeLocationAddressFaxNumber": "785-505-5312",
"EnumerationDate": "11/17/2021",
"LastUpdateDate": "12/11/2024",
"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": "363L00000X",
"TaxonomyName": "Nurse Practitioner",
"LicenseNumber": "53-80585",
"LicenseNumberStateCode": "KS",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}