{
"Npi": {
"NPI": "1356933428",
"EntityType": "Individual",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": "Y",
"IsOrgSubpart": null,
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": null,
"LastName": "MESINA",
"FirstName": "ANASTACIA",
"MiddleName": "AUSTRIACO",
"NamePrefix": "MS.",
"NameSuffix": null,
"Credential": "PA-C",
"OtherOrgName": null,
"OtherOrgNameTypeCode": null,
"OtherLastName": null,
"OtherFirstName": null,
"OtherMiddleName": null,
"OtherNamePrefix": null,
"OtherNameSuffix": null,
"OtherCredential": null,
"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "7895 GRAND BLVD",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "HOBART",
"MailingAddressStateName": "IN",
"MailingAddressPostalCode": "46342-6665",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "219-947-1910",
"MailingAddressFaxNumber": "219-942-3829",
"FirstLinePracticeLocationAddress": "101 E 87TH AVE STE 420",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "MERRILLVILLE",
"PracticeLocationAddressStateName": "IN",
"PracticeLocationAddressPostalCode": "46410-7335",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "219-947-1910",
"PracticeLocationAddressFaxNumber": "219-769-2313",
"EnumerationDate": "02/09/2021",
"LastUpdateDate": "01/17/2022",
"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": "363AM0700X",
"TaxonomyName": "Medical Physician Assistant",
"LicenseNumber": "10003220A",
"LicenseNumberStateCode": "IN",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": {
"HealthcareProviderTaxonomyGroup": {
"HealthcareProviderTaxonomyGroupName": "193400000X SINGLE SPECIALTY GROUP",
"HealthcareProviderTaxonomyGroupDescription": "Single Specialty Group - A business group of one or more individual practitioners, all of who practice with the same area of specialization."
}
}
}
}