NPI Code Detail JSON Logo

1194380394 NPI number — MEGAN E MILLSAP DPT

NPI Number: 1194380394
Health Care Provider/Practitioner: MEGAN E MILLSAP DPT

Information about “1194380394” NPI (MEGAN E MILLSAP DPT) exists in 1194380394 in HTML format HTML  |  1194380394 in plain Text format TXT  |  1194380394 in PDF (Portable Document Format) PDF  |  1194380394 in an XML format XML  formats.

NPI Number : 1194380394 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1194380394",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "N",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "MILLSAP",
    "FirstName": "MEGAN",
    "MiddleName": "E",
    "NamePrefix": null,
    "NameSuffix": null,
    "Credential": "DPT",
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": "ROBERT",
    "OtherFirstName": "MEGAN",
    "OtherMiddleName": "E",
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": "DPT",
    "OtherLastNameTypeCode": "1",
    "FirstLineMailingAddress": "6419 LAKEWOOD DR W",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "TACOMA",
    "MailingAddressStateName": "WA",
    "MailingAddressPostalCode": "98467-3331",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "541-844-4730",
    "MailingAddressFaxNumber": null,
    "FirstLinePracticeLocationAddress": "6419 LAKEWOOD DR W",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "TACOMA",
    "PracticeLocationAddressStateName": "WA",
    "PracticeLocationAddressPostalCode": "98467-3331",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "532-531-8873",
    "PracticeLocationAddressFaxNumber": null,
    "EnumerationDate": "05/03/2019",
    "LastUpdateDate": "12/11/2024",
    "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": "225100000X",
          "TaxonomyName": "Physical Therapist",
          "LicenseNumber": "4456",
          "LicenseNumberStateCode": "HI",
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "225100000X",
          "TaxonomyName": "Physical Therapist",
          "LicenseNumber": "62289",
          "LicenseNumberStateCode": "OR",
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "2251P0200X",
          "TaxonomyName": "Pediatric Physical Therapist",
          "LicenseNumber": "60965278",
          "LicenseNumberStateCode": "WA",
          "PrimaryTaxonomySwitch": "Y"
        }
      ]
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

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