{
"Npi": {
"NPI": "1477938298",
"EntityType": "Individual",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": "N",
"IsOrgSubpart": null,
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": null,
"LastName": "BELINA",
"FirstName": "KIMBERLY",
"MiddleName": null,
"NamePrefix": null,
"NameSuffix": null,
"Credential": "PA-C",
"OtherOrgName": null,
"OtherOrgNameTypeCode": null,
"OtherLastName": null,
"OtherFirstName": null,
"OtherMiddleName": null,
"OtherNamePrefix": null,
"OtherNameSuffix": null,
"OtherCredential": null,
"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "300 CONGRESS ST STE 304",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "QUINCY",
"MailingAddressStateName": "MA",
"MailingAddressPostalCode": "02169-0907",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "617-773-2200",
"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "300 CONGRESS ST STE 304",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "QUINCY",
"PracticeLocationAddressStateName": "MA",
"PracticeLocationAddressPostalCode": "02169-0907",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "617-773-2200",
"PracticeLocationAddressFaxNumber": "617-773-2202",
"EnumerationDate": "07/22/2015",
"LastUpdateDate": "11/13/2025",
"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": "363A00000X",
"TaxonomyName": "Physician Assistant",
"LicenseNumber": "PA5410",
"LicenseNumberStateCode": "MA",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}