{
"Npi": {
"NPI": "1194435669",
"EntityType": "Individual",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": "Y",
"IsOrgSubpart": null,
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": null,
"LastName": "KIDD-SIMMONS",
"FirstName": "TRINA",
"MiddleName": "SERENA",
"NamePrefix": "PROF.",
"NameSuffix": null,
"Credential": "TRANSPPRTION PROVIDE",
"OtherOrgName": null,
"OtherOrgNameTypeCode": null,
"OtherLastName": null,
"OtherFirstName": null,
"OtherMiddleName": null,
"OtherNamePrefix": null,
"OtherNameSuffix": null,
"OtherCredential": null,
"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "TRINA KIDD-SIMMONS",
"SecondLineMailingAddress": "131 SCOTT STREET",
"MailingAddressCityName": "REIDSVILLE",
"MailingAddressStateName": "NC",
"MailingAddressPostalCode": "27320",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "336-580-4866",
"MailingAddressFaxNumber": "336-347-7030",
"FirstLinePracticeLocationAddress": "TRINA KIDD-SIMMONS",
"SecondLinePracticeLocationAddress": "131 SCOTT STREET",
"PracticeLocationAddressCityName": "REIDSVILLE",
"PracticeLocationAddressStateName": "NC",
"PracticeLocationAddressPostalCode": "27320",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "336-580-4866",
"PracticeLocationAddressFaxNumber": "336-347-7030",
"EnumerationDate": "11/25/2022",
"LastUpdateDate": "11/25/2022",
"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": "347C00000X",
"TaxonomyName": "Private Vehicle",
"LicenseNumber": "28776506",
"LicenseNumberStateCode": "NC",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}