{
"Npi": {
"NPI": "1154581940",
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"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "PAMLICO PEDIATRIC THERAPY",
"LastName": null,
"FirstName": null,
"MiddleName": null,
"NamePrefix": null,
"NameSuffix": null,
"Credential": null,
"OtherOrgName": null,
"OtherOrgNameTypeCode": null,
"OtherLastName": null,
"OtherFirstName": null,
"OtherMiddleName": null,
"OtherNamePrefix": null,
"OtherNameSuffix": null,
"OtherCredential": null,
"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "111 AVON AVE",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "WASHINGTON",
"MailingAddressStateName": "NC",
"MailingAddressPostalCode": "27889-3840",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "252-975-1234",
"MailingAddressFaxNumber": "252-975-1000",
"FirstLinePracticeLocationAddress": "111 AVON AVE",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "WASHINGTON",
"PracticeLocationAddressStateName": "NC",
"PracticeLocationAddressPostalCode": "27889-3840",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "252-975-1234",
"PracticeLocationAddressFaxNumber": "252-975-1000",
"EnumerationDate": "06/15/2008",
"LastUpdateDate": "06/15/2008",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "OESTREICH",
"AuthorizedOfficialFirstName": "CATHERINE",
"AuthorizedOfficialMiddleName": "AMANDA",
"AuthorizedOfficialTitle": "OCCUPATIONAL THERAPIST/OWNER",
"AuthorizedOfficialNamePrefix": "MS.",
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "OTR/L",
"AuthorizedOfficialTelephoneNumber": "252-975-1234",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "225X00000X",
"TaxonomyName": "Occupational Therapist",
"LicenseNumber": "5144",
"LicenseNumberStateCode": "NC",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": {
"HealthcareProviderTaxonomyGroup": {
"HealthcareProviderTaxonomyGroupName": "193200000X MULTI-SPECIALTY GROUP",
"HealthcareProviderTaxonomyGroupDescription": "Multi-Specialty Group - A business group of one or more individual practitioners, who practice with different areas of specialization."
}
}
}
}