{
"Npi": {
"NPI": "1508042896",
"EntityType": "Individual",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": "N",
"IsOrgSubpart": null,
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": null,
"LastName": "JOHN",
"FirstName": "STANLEY",
"MiddleName": "ABRAHAM",
"NamePrefix": "MR.",
"NameSuffix": null,
"Credential": "P.T.",
"OtherOrgName": null,
"OtherOrgNameTypeCode": null,
"OtherLastName": "JOHN",
"OtherFirstName": "STANLEY",
"OtherMiddleName": "ABRAHAM",
"OtherNamePrefix": null,
"OtherNameSuffix": null,
"OtherCredential": "P.T.",
"OtherLastNameTypeCode": "1",
"FirstLineMailingAddress": "9 HARVEST LN",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "FARMINGTON",
"MailingAddressStateName": "CT",
"MailingAddressPostalCode": "06032-3105",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "860-404-2201",
"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "HFSC,2150 CORBIN AVE",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "NEW BRIATIN",
"PracticeLocationAddressStateName": "CT",
"PracticeLocationAddressPostalCode": "06053",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "860-827-1958",
"PracticeLocationAddressFaxNumber": "860-827-4947",
"EnumerationDate": "01/16/2008",
"LastUpdateDate": "04/17/2008",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": "M",
"Gender": "Male",
"AuthorizedOfficialLastName": null,
"AuthorizedOfficialFirstName": null,
"AuthorizedOfficialMiddleName": null,
"AuthorizedOfficialTitle": null,
"AuthorizedOfficialNamePrefix": null,
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": null,
"AuthorizedOfficialTelephoneNumber": null,
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "225100000X",
"TaxonomyName": "Physical Therapist",
"LicenseNumber": "004996",
"LicenseNumberStateCode": "CT",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}