{
"Npi": {
"NPI": "1356882310",
"EntityType": "Individual",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": "Y",
"IsOrgSubpart": null,
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": null,
"LastName": "BRATHWAITE",
"FirstName": "AMANDA",
"MiddleName": null,
"NamePrefix": "MS.",
"NameSuffix": null,
"Credential": "MASSSAGE THERAPIST.",
"OtherOrgName": null,
"OtherOrgNameTypeCode": null,
"OtherLastName": null,
"OtherFirstName": null,
"OtherMiddleName": null,
"OtherNamePrefix": null,
"OtherNameSuffix": null,
"OtherCredential": null,
"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "5871 GRAYWOOD CIR SE",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "MABLETON",
"MailingAddressStateName": "GA",
"MailingAddressPostalCode": "30126-2895",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "404-861-6282",
"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "264 19TH ST NW",
"SecondLinePracticeLocationAddress": "2230",
"PracticeLocationAddressCityName": "ATLANTA",
"PracticeLocationAddressStateName": "GA",
"PracticeLocationAddressPostalCode": "30363-1135",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "404-861-6282",
"PracticeLocationAddressFaxNumber": null,
"EnumerationDate": "03/10/2017",
"LastUpdateDate": "03/10/2017",
"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": "225700000X",
"TaxonomyName": "Massage Therapist",
"LicenseNumber": "MT000610",
"LicenseNumberStateCode": "GA",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}