{
"Npi": {
"NPI": "1407103435",
"EntityType": "Individual",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": "N",
"IsOrgSubpart": null,
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": null,
"LastName": "BACKUS",
"FirstName": "CHRISTINE",
"MiddleName": "SARAH",
"NamePrefix": null,
"NameSuffix": null,
"Credential": "PT",
"OtherOrgName": null,
"OtherOrgNameTypeCode": null,
"OtherLastName": "HILL",
"OtherFirstName": "CHRISTINE",
"OtherMiddleName": "S",
"OtherNamePrefix": null,
"OtherNameSuffix": null,
"OtherCredential": "PT",
"OtherLastNameTypeCode": "1",
"FirstLineMailingAddress": "39 HOSPITAL CENTER CMNS",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "HILTON HEAD ISLAND",
"MailingAddressStateName": "SC",
"MailingAddressPostalCode": "29926-2837",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "843-689-2233",
"MailingAddressFaxNumber": "843-689-2234",
"FirstLinePracticeLocationAddress": "39 HOSPITAL CENTER CMNS",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "HILTON HEAD ISLAND",
"PracticeLocationAddressStateName": "SC",
"PracticeLocationAddressPostalCode": "29926-2837",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "843-689-2233",
"PracticeLocationAddressFaxNumber": "843-689-2234",
"EnumerationDate": "08/09/2012",
"LastUpdateDate": "01/06/2025",
"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": "P17032",
"LicenseNumberStateCode": "NC",
"PrimaryTaxonomySwitch": "N"
},
{
"TaxonomyCode": "225100000X",
"TaxonomyName": "Physical Therapist",
"LicenseNumber": "035274",
"LicenseNumberStateCode": "NY",
"PrimaryTaxonomySwitch": "N"
},
{
"TaxonomyCode": "225100000X",
"TaxonomyName": "Physical Therapist",
"LicenseNumber": "12679",
"LicenseNumberStateCode": "SC",
"PrimaryTaxonomySwitch": "Y"
}
]
},
"HealthcareProviderTaxonomyGroups": null
}
}