{
"Npi": {
"NPI": "1154648251",
"EntityType": "Individual",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": "Y",
"IsOrgSubpart": null,
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": null,
"LastName": "CHAVERS",
"FirstName": "CRYSTAL",
"MiddleName": "ANN",
"NamePrefix": "MRS.",
"NameSuffix": null,
"Credential": "RDMS,RVT",
"OtherOrgName": null,
"OtherOrgNameTypeCode": null,
"OtherLastName": "MILLS",
"OtherFirstName": "CRYSTAL",
"OtherMiddleName": "ANN",
"OtherNamePrefix": null,
"OtherNameSuffix": null,
"OtherCredential": "RDMS,RVT",
"OtherLastNameTypeCode": "1",
"FirstLineMailingAddress": "4422 SE BEAVER LN",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "STUART",
"MailingAddressStateName": "FL",
"MailingAddressPostalCode": "34997-5528",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "561-389-4314",
"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "601 W LEOTA ST",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "NORTH PLATTE",
"PracticeLocationAddressStateName": "NE",
"PracticeLocationAddressPostalCode": "69101-6525",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "308-696-8000",
"PracticeLocationAddressFaxNumber": null,
"EnumerationDate": "04/28/2010",
"LastUpdateDate": "04/28/2010",
"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": "2471V0105X",
"TaxonomyName": "Vascular Sonography Radiologic Technologist",
"LicenseNumber": "120173",
"LicenseNumberStateCode": "MD",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}