{
"Npi": {
"NPI": "1306256961",
"EntityType": "Individual",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": "Y",
"IsOrgSubpart": null,
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": null,
"LastName": "GERISILO",
"FirstName": "DEBORAH",
"MiddleName": null,
"NamePrefix": null,
"NameSuffix": null,
"Credential": "COTA/L",
"OtherOrgName": null,
"OtherOrgNameTypeCode": null,
"OtherLastName": null,
"OtherFirstName": null,
"OtherMiddleName": null,
"OtherNamePrefix": null,
"OtherNameSuffix": null,
"OtherCredential": null,
"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "28150 N ALMA SCHOOL PKWY",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "SCOTTSDALE",
"MailingAddressStateName": "AZ",
"MailingAddressPostalCode": "85262-8048",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "480-262-0496",
"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "15414 N 7TH ST",
"SecondLinePracticeLocationAddress": "SUITE 3",
"PracticeLocationAddressCityName": "PHOENIX",
"PracticeLocationAddressStateName": "AZ",
"PracticeLocationAddressPostalCode": "85022-3519",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "602-476-7519",
"PracticeLocationAddressFaxNumber": "602-445-4971",
"EnumerationDate": "05/05/2014",
"LastUpdateDate": "05/06/2014",
"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": "5557",
"LicenseNumberStateCode": "AZ",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}