{
"Npi": {
"NPI": "1275821613",
"EntityType": "Individual",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": "N",
"IsOrgSubpart": null,
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": null,
"LastName": "GAITOR",
"FirstName": "MAUREEN",
"MiddleName": null,
"NamePrefix": null,
"NameSuffix": null,
"Credential": "OTL",
"OtherOrgName": null,
"OtherOrgNameTypeCode": null,
"OtherLastName": null,
"OtherFirstName": null,
"OtherMiddleName": null,
"OtherNamePrefix": null,
"OtherNameSuffix": null,
"OtherCredential": null,
"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "4635 SPRING CANYON HTS",
"SecondLineMailingAddress": "APARTMENT 202",
"MailingAddressCityName": "COLORADO SPRINGS",
"MailingAddressStateName": "CO",
"MailingAddressPostalCode": "80907-9401",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "518-441-8524",
"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "4635 SPRING CANYON HTS",
"SecondLinePracticeLocationAddress": "APARTMENT 202",
"PracticeLocationAddressCityName": "COLORADO SPRINGS",
"PracticeLocationAddressStateName": "CO",
"PracticeLocationAddressPostalCode": "80907-9401",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "518-441-8524",
"PracticeLocationAddressFaxNumber": null,
"EnumerationDate": "07/19/2011",
"LastUpdateDate": "11/16/2016",
"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": "225X00000X",
"TaxonomyName": "Occupational Therapist",
"LicenseNumber": "2090",
"LicenseNumberStateCode": "NH",
"PrimaryTaxonomySwitch": "N"
},
{
"TaxonomyCode": "225X00000X",
"TaxonomyName": "Occupational Therapist",
"LicenseNumber": "10250",
"LicenseNumberStateCode": "MA",
"PrimaryTaxonomySwitch": "N"
},
{
"TaxonomyCode": "225X00000X",
"TaxonomyName": "Occupational Therapist",
"LicenseNumber": "072.0077695",
"LicenseNumberStateCode": "VT",
"PrimaryTaxonomySwitch": "N"
},
{
"TaxonomyCode": "225X00000X",
"TaxonomyName": "Occupational Therapist",
"LicenseNumber": "3185",
"LicenseNumberStateCode": "CO",
"PrimaryTaxonomySwitch": "Y"
}
]
},
"HealthcareProviderTaxonomyGroups": null
}
}