{
"Npi": {
"NPI": "1114748423",
"EntityType": "Individual",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": "Y",
"IsOrgSubpart": null,
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": null,
"LastName": "LEWIS SMITH",
"FirstName": "CEREESE",
"MiddleName": "N",
"NamePrefix": null,
"NameSuffix": null,
"Credential": null,
"OtherOrgName": null,
"OtherOrgNameTypeCode": null,
"OtherLastName": "LEWIS SMITH",
"OtherFirstName": "CEREESE",
"OtherMiddleName": null,
"OtherNamePrefix": null,
"OtherNameSuffix": null,
"OtherCredential": "MHA, MSN, RN",
"OtherLastNameTypeCode": "2",
"FirstLineMailingAddress": "PO BOX 304867",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "ST.THOMAS",
"MailingAddressStateName": "VIRGIN ISLANDS",
"MailingAddressPostalCode": "00803",
"MailingAddressCountryCode": "UM",
"MailingAddressTelephoneNumber": null,
"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "PO BOX 304867",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "ST.THOMAS",
"PracticeLocationAddressStateName": "VIRGIN ISLANDS",
"PracticeLocationAddressPostalCode": "00803",
"PracticeLocationAddressCountryCode": "UM",
"PracticeLocationAddressTelephoneNumber": "340-642-6773",
"PracticeLocationAddressFaxNumber": null,
"EnumerationDate": "10/19/2024",
"LastUpdateDate": "10/19/2024",
"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": "163WC0400X",
"TaxonomyName": "Case Management Registered Nurse",
"LicenseNumber": "6065",
"LicenseNumberStateCode": "VI",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": {
"HealthcareProviderTaxonomyGroup": {
"HealthcareProviderTaxonomyGroupName": "193400000X SINGLE SPECIALTY GROUP",
"HealthcareProviderTaxonomyGroupDescription": "Single Specialty Group - A business group of one or more individual practitioners, all of who practice with the same area of specialization."
}
}
}
}