{
"Npi": {
"NPI": "1205057049",
"EntityType": "Individual",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": "Y",
"IsOrgSubpart": null,
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": null,
"LastName": "DAVIS",
"FirstName": "GUSTAVIA",
"MiddleName": "C",
"NamePrefix": "MS.",
"NameSuffix": null,
"Credential": "LCOTA",
"OtherOrgName": null,
"OtherOrgNameTypeCode": null,
"OtherLastName": "DAVIS-LYONS",
"OtherFirstName": "GUSTAVIA",
"OtherMiddleName": "C",
"OtherNamePrefix": "MS.",
"OtherNameSuffix": null,
"OtherCredential": "LCOTA",
"OtherLastNameTypeCode": "1",
"FirstLineMailingAddress": "8551 OLIVER AVE",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "BATON ROUGE",
"MailingAddressStateName": "LA",
"MailingAddressPostalCode": "70809-1730",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "225-716-2880",
"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "1306 W ADMIRAL DOYLE DR",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "NEW IBERIA",
"PracticeLocationAddressStateName": "LA",
"PracticeLocationAddressPostalCode": "70560-8552",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "337-364-5472",
"PracticeLocationAddressFaxNumber": null,
"EnumerationDate": "05/01/2007",
"LastUpdateDate": "02/13/2013",
"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": "224Z00000X",
"TaxonomyName": "Occupational Therapy Assistant",
"LicenseNumber": "OTA.Z20612",
"LicenseNumberStateCode": "LA",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}