{
"Npi": {
"NPI": "1326681107",
"EntityType": "Individual",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": "Y",
"IsOrgSubpart": null,
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": null,
"LastName": "SHACKLETON",
"FirstName": "JUDITH",
"MiddleName": "AMBER",
"NamePrefix": "MRS.",
"NameSuffix": null,
"Credential": "OTR/L",
"OtherOrgName": null,
"OtherOrgNameTypeCode": null,
"OtherLastName": "SHACKLETON",
"OtherFirstName": "JUDY",
"OtherMiddleName": "A",
"OtherNamePrefix": "MRS.",
"OtherNameSuffix": null,
"OtherCredential": "OTR/L",
"OtherLastNameTypeCode": "5",
"FirstLineMailingAddress": "8323 REGENCY WOODS WAY",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "LOUISVILLE",
"MailingAddressStateName": "KY",
"MailingAddressPostalCode": "40220-3817",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "502-548-1209",
"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "100 ENVOY CIR UNIT 101",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "LOUISVILLE",
"PracticeLocationAddressStateName": "KY",
"PracticeLocationAddressPostalCode": "40299-1807",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "502-896-5669",
"PracticeLocationAddressFaxNumber": null,
"EnumerationDate": "10/23/2019",
"LastUpdateDate": "10/23/2019",
"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": "134527",
"LicenseNumberStateCode": "KY",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}