{
"Npi": {
"NPI": "1508288820",
"EntityType": "Individual",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": "N",
"IsOrgSubpart": null,
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": null,
"LastName": "ANIMASHAUN",
"FirstName": "AGNES",
"MiddleName": null,
"NamePrefix": "MS.",
"NameSuffix": null,
"Credential": "PA",
"OtherOrgName": null,
"OtherOrgNameTypeCode": null,
"OtherLastName": "OTUEDON-ANIMASHAUN",
"OtherFirstName": "AGNES",
"OtherMiddleName": null,
"OtherNamePrefix": null,
"OtherNameSuffix": null,
"OtherCredential": null,
"OtherLastNameTypeCode": "1",
"FirstLineMailingAddress": "899 NORTH CAPITOL STREET NE ROOM 4000",
"SecondLineMailingAddress": "DISTRICT OF COLUMBIA DEPT. OF HEALTH, STD/ TB DIV.",
"MailingAddressCityName": "DISTRICT OF COLUMBIA",
"MailingAddressStateName": "DC",
"MailingAddressPostalCode": "20002",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "202-671-4843",
"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "1900 MASSACHUSETTS AVE, SE, BLD 6,8",
"SecondLinePracticeLocationAddress": "STD CLINIC",
"PracticeLocationAddressCityName": "WASHINGTON",
"PracticeLocationAddressStateName": "DC",
"PracticeLocationAddressPostalCode": "20003",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "202-698-4750",
"PracticeLocationAddressFaxNumber": null,
"EnumerationDate": "01/07/2014",
"LastUpdateDate": "01/07/2014",
"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": "PA30118",
"LicenseNumberStateCode": "DC",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}