{
"Npi": {
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"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": "Y",
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"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": null,
"LastName": "MEHNER",
"FirstName": "AMANDA",
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"NamePrefix": "MRS.",
"NameSuffix": null,
"Credential": "LMT",
"OtherOrgName": null,
"OtherOrgNameTypeCode": null,
"OtherLastName": "CARPENTER",
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"OtherNamePrefix": null,
"OtherNameSuffix": null,
"OtherCredential": "LMT",
"OtherLastNameTypeCode": "1",
"FirstLineMailingAddress": "612 S WELLS ST",
"SecondLineMailingAddress": "SUITE C",
"MailingAddressCityName": "LAKE GENEVA",
"MailingAddressStateName": "WI",
"MailingAddressPostalCode": "53147-2159",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "262-248-8177",
"MailingAddressFaxNumber": "262-248-6393",
"FirstLinePracticeLocationAddress": "612 S WELLS ST",
"SecondLinePracticeLocationAddress": "SUITE C",
"PracticeLocationAddressCityName": "LAKE GENEVA",
"PracticeLocationAddressStateName": "WI",
"PracticeLocationAddressPostalCode": "53147-2159",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "262-248-8177",
"PracticeLocationAddressFaxNumber": "262-248-6393",
"EnumerationDate": "12/07/2012",
"LastUpdateDate": "12/07/2012",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": "F",
"Gender": "Female",
"AuthorizedOfficialLastName": null,
"AuthorizedOfficialFirstName": null,
"AuthorizedOfficialMiddleName": null,
"AuthorizedOfficialTitle": null,
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"AuthorizedOfficialCredential": null,
"AuthorizedOfficialTelephoneNumber": null,
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "225700000X",
"TaxonomyName": "Massage Therapist",
"LicenseNumber": "10312-146",
"LicenseNumberStateCode": "WI",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}