{
"Npi": {
"NPI": "1306167564",
"EntityType": "Individual",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": "N",
"IsOrgSubpart": null,
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": null,
"LastName": "SANDERS",
"FirstName": "DANIELLE",
"MiddleName": "TERESA",
"NamePrefix": "DR.",
"NameSuffix": null,
"Credential": "M.D.",
"OtherOrgName": null,
"OtherOrgNameTypeCode": null,
"OtherLastName": "STEVENS",
"OtherFirstName": "DANIELLE",
"OtherMiddleName": "TERESA",
"OtherNamePrefix": "DR.",
"OtherNameSuffix": null,
"OtherCredential": "M.D.",
"OtherLastNameTypeCode": "1",
"FirstLineMailingAddress": "4022 SANDALWOOD DR",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "ERIE",
"MailingAddressStateName": "PA",
"MailingAddressPostalCode": "16506-4764",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "814-833-5124",
"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "3901 LIBERTY ST",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "ERIE",
"PracticeLocationAddressStateName": "PA",
"PracticeLocationAddressPostalCode": "16509-1689",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "814-864-5595",
"PracticeLocationAddressFaxNumber": null,
"EnumerationDate": "06/22/2010",
"LastUpdateDate": "09/08/2021",
"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": "207Q00000X",
"TaxonomyName": "Family Medicine Physician",
"LicenseNumber": "MD441741",
"LicenseNumberStateCode": "PA",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}