{
"Npi": {
"NPI": "1497408645",
"EntityType": "Individual",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": "N",
"IsOrgSubpart": null,
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": null,
"LastName": "SHAW",
"FirstName": "BROOKE",
"MiddleName": "ALLISON",
"NamePrefix": null,
"NameSuffix": null,
"Credential": "RN",
"OtherOrgName": null,
"OtherOrgNameTypeCode": null,
"OtherLastName": "HUMMEL",
"OtherFirstName": "BROOKE",
"OtherMiddleName": "ALLISON",
"OtherNamePrefix": null,
"OtherNameSuffix": null,
"OtherCredential": "RN",
"OtherLastNameTypeCode": "1",
"FirstLineMailingAddress": "163 MEADOW SPRING CT",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "TEMPLE",
"MailingAddressStateName": "GA",
"MailingAddressPostalCode": "30179-5090",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "770-843-3529",
"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "1390 MARKET ST STE 200",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "SAN FRANCISCO",
"PracticeLocationAddressStateName": "CA",
"PracticeLocationAddressPostalCode": "94102-5404",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "800-504-5360",
"PracticeLocationAddressFaxNumber": null,
"EnumerationDate": "01/28/2022",
"LastUpdateDate": "01/28/2022",
"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": "163W00000X",
"TaxonomyName": "Registered Nurse",
"LicenseNumber": "RN279628",
"LicenseNumberStateCode": "GA",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}