{
"Npi": {
"NPI": "1346521622",
"EntityType": "Individual",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": "N",
"IsOrgSubpart": null,
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": null,
"LastName": "SMITH",
"FirstName": "SUZANNE",
"MiddleName": "MARGARET",
"NamePrefix": "DR.",
"NameSuffix": null,
"Credential": "MD",
"OtherOrgName": null,
"OtherOrgNameTypeCode": null,
"OtherLastName": null,
"OtherFirstName": null,
"OtherMiddleName": null,
"OtherNamePrefix": null,
"OtherNameSuffix": null,
"OtherCredential": null,
"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "PO BOX 291943",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "NASHVILLE",
"MailingAddressStateName": "TN",
"MailingAddressPostalCode": "37229-1943",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "833-952-0829",
"MailingAddressFaxNumber": "615-237-1434",
"FirstLinePracticeLocationAddress": "489 BERNARDSTON RD STE 108",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "GREENFIELD",
"PracticeLocationAddressStateName": "MA",
"PracticeLocationAddressPostalCode": "01301-1239",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "833-952-0829",
"PracticeLocationAddressFaxNumber": "615-237-1434",
"EnumerationDate": "08/31/2011",
"LastUpdateDate": "02/19/2024",
"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": "2083A0300X",
"TaxonomyName": "Addiction Medicine (Preventive Medicine) Physician",
"LicenseNumber": "207840",
"LicenseNumberStateCode": "MA",
"PrimaryTaxonomySwitch": "N"
},
{
"TaxonomyCode": "207RA0401X",
"TaxonomyName": "Addiction Medicine (Internal Medicine) Physician",
"LicenseNumber": "207840",
"LicenseNumberStateCode": "MA",
"PrimaryTaxonomySwitch": "Y"
}
]
},
"HealthcareProviderTaxonomyGroups": null
}
}