{
"Npi": {
"NPI": "1164156576",
"EntityType": "Individual",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": "Y",
"IsOrgSubpart": null,
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": null,
"LastName": "STATEN",
"FirstName": "CAMELA",
"MiddleName": "ROBIN",
"NamePrefix": "MS.",
"NameSuffix": null,
"Credential": "INDEPENDENT PROVIDER",
"OtherOrgName": null,
"OtherOrgNameTypeCode": null,
"OtherLastName": null,
"OtherFirstName": null,
"OtherMiddleName": null,
"OtherNamePrefix": null,
"OtherNameSuffix": null,
"OtherCredential": null,
"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "4115 BRANDT MEADOWS DR",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "DAYTON",
"MailingAddressStateName": "OH",
"MailingAddressPostalCode": "45404-2006",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "937-305-3884",
"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "4349 EASTON WAY STE 200",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "COLUMBUS",
"PracticeLocationAddressStateName": "OH",
"PracticeLocationAddressPostalCode": "43219-0001",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "888-704-3010",
"PracticeLocationAddressFaxNumber": null,
"EnumerationDate": "07/12/2022",
"LastUpdateDate": "07/12/2022",
"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": null,
"LicenseNumberStateCode": null,
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}