{
"Npi": {
"NPI": "1124367115",
"EntityType": "Individual",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": "N",
"IsOrgSubpart": null,
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": null,
"LastName": "NEIL",
"FirstName": "SHANNON",
"MiddleName": "MARIE",
"NamePrefix": null,
"NameSuffix": null,
"Credential": null,
"OtherOrgName": null,
"OtherOrgNameTypeCode": null,
"OtherLastName": "TIPPENS",
"OtherFirstName": "SHANNON",
"OtherMiddleName": "MARIE",
"OtherNamePrefix": null,
"OtherNameSuffix": null,
"OtherCredential": null,
"OtherLastNameTypeCode": "1",
"FirstLineMailingAddress": "8839 N BALES AVE",
"SecondLineMailingAddress": "APT/SUITE",
"MailingAddressCityName": "KANSAS CITY",
"MailingAddressStateName": "MO",
"MailingAddressPostalCode": "64156-8939",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "972-567-8304",
"MailingAddressFaxNumber": "913-652-9198",
"FirstLinePracticeLocationAddress": "6700 ANTIOCH RD",
"SecondLinePracticeLocationAddress": "SUITE 120",
"PracticeLocationAddressCityName": "MERRIAM",
"PracticeLocationAddressStateName": "KS",
"PracticeLocationAddressPostalCode": "66204-1497",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "972-567-8304",
"PracticeLocationAddressFaxNumber": "913-652-9198",
"EnumerationDate": "02/11/2013",
"LastUpdateDate": "02/11/2013",
"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": "225X00000X",
"TaxonomyName": "Occupational Therapist",
"LicenseNumber": "2013000059",
"LicenseNumberStateCode": "MO",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}