{
"Npi": {
"NPI": "1356930663",
"EntityType": "Individual",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": "N",
"IsOrgSubpart": null,
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": null,
"LastName": "CHAPIN",
"FirstName": "KARMEN",
"MiddleName": null,
"NamePrefix": null,
"NameSuffix": null,
"Credential": "DPT",
"OtherOrgName": null,
"OtherOrgNameTypeCode": null,
"OtherLastName": null,
"OtherFirstName": null,
"OtherMiddleName": null,
"OtherNamePrefix": null,
"OtherNameSuffix": null,
"OtherCredential": null,
"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "2069 COURSE LANE",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "SURF CITY",
"MailingAddressStateName": "NC",
"MailingAddressPostalCode": "28445",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "760-583-0826",
"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "7532 WILKINS DR",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "FAYETTEVILLE",
"PracticeLocationAddressStateName": "NC",
"PracticeLocationAddressPostalCode": "28311-9338",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "910-868-6000",
"PracticeLocationAddressFaxNumber": null,
"EnumerationDate": "01/12/2021",
"LastUpdateDate": "09/26/2024",
"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": "225100000X",
"TaxonomyName": "Physical Therapist",
"LicenseNumber": "P23522",
"LicenseNumberStateCode": "NC",
"PrimaryTaxonomySwitch": "Y"
},
{
"TaxonomyCode": "225100000X",
"TaxonomyName": "Physical Therapist",
"LicenseNumber": "25297",
"LicenseNumberStateCode": "MA",
"PrimaryTaxonomySwitch": "N"
}
]
},
"HealthcareProviderTaxonomyGroups": null
}
}