{
"Npi": {
"NPI": "1497165443",
"EntityType": "Individual",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": "N",
"IsOrgSubpart": null,
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": null,
"LastName": "OSEDO-BLEECHER",
"FirstName": "VANESSA",
"MiddleName": "DE DOMENICO",
"NamePrefix": "DR.",
"NameSuffix": null,
"Credential": "M.D.",
"OtherOrgName": null,
"OtherOrgNameTypeCode": null,
"OtherLastName": "NONE",
"OtherFirstName": "NONE",
"OtherMiddleName": null,
"OtherNamePrefix": null,
"OtherNameSuffix": null,
"OtherCredential": "MD",
"OtherLastNameTypeCode": "5",
"FirstLineMailingAddress": "64-1035 MAMALAHOA HWY STE K",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "KAMUELA",
"MailingAddressStateName": "HI",
"MailingAddressPostalCode": "96743-8440",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "808-885-4503",
"MailingAddressFaxNumber": "808-883-9683",
"FirstLinePracticeLocationAddress": "64-1035 MAMALAHOA HWY STE K",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "KAMUELA",
"PracticeLocationAddressStateName": "HI",
"PracticeLocationAddressPostalCode": "96743-8440",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "808-885-4507",
"PracticeLocationAddressFaxNumber": "808-883-9683",
"EnumerationDate": "04/29/2014",
"LastUpdateDate": "01/24/2018",
"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": "390200000X",
"TaxonomyName": "Student in an Organized Health Care Education/Training Program",
"LicenseNumber": null,
"LicenseNumberStateCode": null,
"PrimaryTaxonomySwitch": "N"
},
{
"TaxonomyCode": "207R00000X",
"TaxonomyName": "Internal Medicine Physician",
"LicenseNumber": "18437",
"LicenseNumberStateCode": "HI",
"PrimaryTaxonomySwitch": "Y"
}
]
},
"HealthcareProviderTaxonomyGroups": null
}
}