{
"Npi": {
"NPI": "1366747891",
"EntityType": "Individual",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": "N",
"IsOrgSubpart": null,
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": null,
"LastName": "GONCALVES",
"FirstName": "SHERYL",
"MiddleName": "KATHLEEN",
"NamePrefix": "MRS.",
"NameSuffix": null,
"Credential": "DPT, PT",
"OtherOrgName": null,
"OtherOrgNameTypeCode": null,
"OtherLastName": null,
"OtherFirstName": null,
"OtherMiddleName": null,
"OtherNamePrefix": null,
"OtherNameSuffix": null,
"OtherCredential": null,
"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "8503 BROMLEY CT",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "ANNANDALE",
"MailingAddressStateName": "VA",
"MailingAddressPostalCode": "22003-4533",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "571-239-5830",
"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "11240 WAPLES MILL RD",
"SecondLinePracticeLocationAddress": "SUITE 101",
"PracticeLocationAddressCityName": "FAIRFAX",
"PracticeLocationAddressStateName": "VA",
"PracticeLocationAddressPostalCode": "22030-6078",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "703-237-2219",
"PracticeLocationAddressFaxNumber": null,
"EnumerationDate": "01/13/2011",
"LastUpdateDate": "12/03/2013",
"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": "2251P0200X",
"TaxonomyName": "Pediatric Physical Therapist",
"LicenseNumber": "2305205015",
"LicenseNumberStateCode": "VA",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}