{
"Npi": {
"NPI": "1154815447",
"EntityType": "Individual",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": "Y",
"IsOrgSubpart": null,
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": null,
"LastName": "MBAKEM",
"FirstName": "FUANYA",
"MiddleName": "R",
"NamePrefix": "MISS",
"NameSuffix": null,
"Credential": "HHA",
"OtherOrgName": null,
"OtherOrgNameTypeCode": null,
"OtherLastName": null,
"OtherFirstName": null,
"OtherMiddleName": null,
"OtherNamePrefix": null,
"OtherNameSuffix": null,
"OtherCredential": null,
"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "4203 WINDFLOWER WAY",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "BOWIE",
"MailingAddressStateName": "MD",
"MailingAddressPostalCode": "20720-4293",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "240-548-8291",
"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "3500 18TH ST NE",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "WASHINGTON",
"PracticeLocationAddressStateName": "DC",
"PracticeLocationAddressPostalCode": "20018-2738",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "202-529-6510",
"PracticeLocationAddressFaxNumber": "202-529-6570",
"EnumerationDate": "06/19/2018",
"LastUpdateDate": "06/19/2018",
"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": "374U00000X",
"TaxonomyName": "Home Health Aide",
"LicenseNumber": "HHA13756",
"LicenseNumberStateCode": "DC",
"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."
}
}
}
}