{
"Npi": {
"NPI": "1124374376",
"EntityType": "Individual",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": "N",
"IsOrgSubpart": null,
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": null,
"LastName": "NICEWARNER",
"FirstName": "LINDA",
"MiddleName": "BEA ALLEN",
"NamePrefix": "MRS.",
"NameSuffix": null,
"Credential": "LPTA",
"OtherOrgName": null,
"OtherOrgNameTypeCode": null,
"OtherLastName": null,
"OtherFirstName": null,
"OtherMiddleName": null,
"OtherNamePrefix": null,
"OtherNameSuffix": null,
"OtherCredential": null,
"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "544 JACKSONS CHASE DR",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "MIDDLETOWN",
"MailingAddressStateName": "VA",
"MailingAddressPostalCode": "22645-3978",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "540-622-7247",
"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "544 JACKSONS CHASE DR",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "MIDDLETOWN",
"PracticeLocationAddressStateName": "VA",
"PracticeLocationAddressPostalCode": "22645-3978",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "540-622-7247",
"PracticeLocationAddressFaxNumber": null,
"EnumerationDate": "07/25/2012",
"LastUpdateDate": "07/25/2012",
"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": "225200000X",
"TaxonomyName": "Physical Therapy Assistant",
"LicenseNumber": "2306000905",
"LicenseNumberStateCode": "VA",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}