{
"Npi": {
"NPI": "1417708496",
"EntityType": "Individual",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": "Y",
"IsOrgSubpart": null,
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": null,
"LastName": "HACKETT",
"FirstName": "TIMBER",
"MiddleName": "LUREE",
"NamePrefix": null,
"NameSuffix": null,
"Credential": null,
"OtherOrgName": null,
"OtherOrgNameTypeCode": null,
"OtherLastName": null,
"OtherFirstName": null,
"OtherMiddleName": null,
"OtherNamePrefix": null,
"OtherNameSuffix": null,
"OtherCredential": null,
"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "1301 CANOPY DR",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "EAST POINT",
"MailingAddressStateName": "GA",
"MailingAddressPostalCode": "30344-1731",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "404-593-4088",
"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "1301 CANOPY DR",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "EAST POINT",
"PracticeLocationAddressStateName": "GA",
"PracticeLocationAddressPostalCode": "30344-1731",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "404-593-4088",
"PracticeLocationAddressFaxNumber": null,
"EnumerationDate": "03/28/2024",
"LastUpdateDate": "03/28/2024",
"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": "171400000X",
"TaxonomyName": "Health & Wellness Coach",
"LicenseNumber": null,
"LicenseNumberStateCode": null,
"PrimaryTaxonomySwitch": "N"
},
{
"TaxonomyCode": "174H00000X",
"TaxonomyName": "Health Educator",
"LicenseNumber": null,
"LicenseNumberStateCode": null,
"PrimaryTaxonomySwitch": "N"
},
{
"TaxonomyCode": "374J00000X",
"TaxonomyName": "Doula",
"LicenseNumber": null,
"LicenseNumberStateCode": null,
"PrimaryTaxonomySwitch": "Y"
}
]
},
"HealthcareProviderTaxonomyGroups": {
"HealthcareProviderTaxonomyGroup": {
"HealthcareProviderTaxonomyGroupName": "193200000X MULTI-SPECIALTY GROUP",
"HealthcareProviderTaxonomyGroupDescription": "Multi-Specialty Group - A business group of one or more individual practitioners, who practice with different areas of specialization."
}
}
}
}