{
"Npi": {
"NPI": "1528133436",
"EntityType": "Individual",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": "Y",
"IsOrgSubpart": null,
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": null,
"LastName": "WITKOWSKI",
"FirstName": "KRYSIA",
"MiddleName": "B",
"NamePrefix": "MRS.",
"NameSuffix": null,
"Credential": "MPT",
"OtherOrgName": null,
"OtherOrgNameTypeCode": null,
"OtherLastName": null,
"OtherFirstName": null,
"OtherMiddleName": null,
"OtherNamePrefix": null,
"OtherNameSuffix": null,
"OtherCredential": null,
"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "1229 MANCHESTER AVE",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "NORFOLK",
"MailingAddressStateName": "VA",
"MailingAddressPostalCode": "23508-1122",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "757-216-4151",
"MailingAddressFaxNumber": "757-216-4152",
"FirstLinePracticeLocationAddress": "350 W 22ND ST",
"SecondLinePracticeLocationAddress": "SUITE 108",
"PracticeLocationAddressCityName": "NORFOLK",
"PracticeLocationAddressStateName": "VA",
"PracticeLocationAddressPostalCode": "23517",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "757-216-4151",
"PracticeLocationAddressFaxNumber": "757-216-4152",
"EnumerationDate": "11/24/2006",
"LastUpdateDate": "07/08/2007",
"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": "225100000X",
"TaxonomyName": "Physical Therapist",
"LicenseNumber": "2305006298",
"LicenseNumberStateCode": "VA",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}