{
"Npi": {
"NPI": "1497933394",
"EntityType": "Individual",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": "N",
"IsOrgSubpart": null,
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": null,
"LastName": "TEIPEN",
"FirstName": "TRACY",
"MiddleName": "M",
"NamePrefix": "MRS.",
"NameSuffix": null,
"Credential": "R.N.",
"OtherOrgName": null,
"OtherOrgNameTypeCode": null,
"OtherLastName": "LARRISON",
"OtherFirstName": "TRACY",
"OtherMiddleName": null,
"OtherNamePrefix": null,
"OtherNameSuffix": null,
"OtherCredential": "R.N., B.S.N",
"OtherLastNameTypeCode": "1",
"FirstLineMailingAddress": "550 N. UNIVERSITY BLVD. UH 1451",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "INDPLS",
"MailingAddressStateName": "IN",
"MailingAddressPostalCode": "46202",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "317-278-1849",
"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "9995 ALLISONVILLE RD",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "FISHERS",
"PracticeLocationAddressStateName": "IN",
"PracticeLocationAddressPostalCode": "46038-2006",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "317-442-1093",
"PracticeLocationAddressFaxNumber": null,
"EnumerationDate": "02/04/2008",
"LastUpdateDate": "08/06/2026",
"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": "101YM0800X",
"TaxonomyName": "Mental Health Counselor",
"LicenseNumber": "88003402A",
"LicenseNumberStateCode": "IN",
"PrimaryTaxonomySwitch": "Y"
},
{
"TaxonomyCode": "163W00000X",
"TaxonomyName": "Registered Nurse",
"LicenseNumber": "28143192A",
"LicenseNumberStateCode": "IN",
"PrimaryTaxonomySwitch": "N"
}
]
},
"HealthcareProviderTaxonomyGroups": null
}
}