{
"Npi": {
"NPI": "1538942420",
"EntityType": "Individual",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": "N",
"IsOrgSubpart": null,
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": null,
"LastName": "CLAY",
"FirstName": "TEMPLE",
"MiddleName": "MERRILL -BAUER",
"NamePrefix": null,
"NameSuffix": null,
"Credential": "LMT",
"OtherOrgName": null,
"OtherOrgNameTypeCode": null,
"OtherLastName": "CLAY",
"OtherFirstName": "TEMPLE",
"OtherMiddleName": null,
"OtherNamePrefix": null,
"OtherNameSuffix": null,
"OtherCredential": "LMT",
"OtherLastNameTypeCode": "2",
"FirstLineMailingAddress": "4-1558 KUHIO HWY",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "KAPAA",
"MailingAddressStateName": "HI",
"MailingAddressPostalCode": "96746-1856",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "808-399-8747",
"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "4-1558 KUHIO HWY",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "KAPAA",
"PracticeLocationAddressStateName": "HI",
"PracticeLocationAddressPostalCode": "96746-1856",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "808-399-8747",
"PracticeLocationAddressFaxNumber": null,
"EnumerationDate": "08/15/2023",
"LastUpdateDate": "08/15/2023",
"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": "225700000X",
"TaxonomyName": "Massage Therapist",
"LicenseNumber": "MAT-16857",
"LicenseNumberStateCode": "HI",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}