{
"Npi": {
"NPI": "1427868504",
"EntityType": "Individual",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": "Y",
"IsOrgSubpart": null,
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": null,
"LastName": "GREGORY",
"FirstName": "CASSANDRA",
"MiddleName": "S",
"NamePrefix": null,
"NameSuffix": null,
"Credential": "DR. OF EDUCATION",
"OtherOrgName": null,
"OtherOrgNameTypeCode": null,
"OtherLastName": "GREGORY",
"OtherFirstName": "CASSANDRA",
"OtherMiddleName": "S",
"OtherNamePrefix": "DR.",
"OtherNameSuffix": null,
"OtherCredential": "CASSANDRA GREGORY",
"OtherLastNameTypeCode": "5",
"FirstLineMailingAddress": "8800 SHADY PINE CT",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "CHARLOTTE",
"MailingAddressStateName": "NC",
"MailingAddressPostalCode": "28214-7116",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "704-287-1935",
"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "2001 CATHERINE SIMMONS AVE",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "CHARLOTTE",
"PracticeLocationAddressStateName": "NC",
"PracticeLocationAddressPostalCode": "28216-4677",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "704-492-1533",
"PracticeLocationAddressFaxNumber": null,
"EnumerationDate": "01/10/2025",
"LastUpdateDate": "01/10/2025",
"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": "405300000X",
"TaxonomyName": "Prevention Professional",
"LicenseNumber": "736559",
"LicenseNumberStateCode": "NC",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}