{
"Npi": {
"NPI": "1265255111",
"EntityType": "Individual",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": "N",
"IsOrgSubpart": null,
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": null,
"LastName": "VABISHCHEVICH",
"FirstName": "VERONICA",
"MiddleName": null,
"NamePrefix": null,
"NameSuffix": null,
"Credential": "PT, DPT",
"OtherOrgName": null,
"OtherOrgNameTypeCode": null,
"OtherLastName": null,
"OtherFirstName": null,
"OtherMiddleName": null,
"OtherNamePrefix": null,
"OtherNameSuffix": null,
"OtherCredential": null,
"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "4420 ROANOKE PKWY APT 304",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "KANSAS CITY",
"MailingAddressStateName": "MO",
"MailingAddressPostalCode": "64111-7268",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "315-941-5728",
"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "19701 W 65TH TER",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "SHAWNEE",
"PracticeLocationAddressStateName": "KS",
"PracticeLocationAddressPostalCode": "66218-9308",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "913-270-0469",
"PracticeLocationAddressFaxNumber": null,
"EnumerationDate": "11/07/2024",
"LastUpdateDate": "11/07/2024",
"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": "11-07754",
"LicenseNumberStateCode": "KS",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}