{
"Npi": {
"NPI": "1548052525",
"EntityType": "Individual",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": "Y",
"IsOrgSubpart": null,
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": null,
"LastName": "LEWIS",
"FirstName": "LEETHA",
"MiddleName": "WYNNE",
"NamePrefix": null,
"NameSuffix": null,
"Credential": "REGISTERED NURSE",
"OtherOrgName": null,
"OtherOrgNameTypeCode": null,
"OtherLastName": "LEWIS",
"OtherFirstName": "LEETHA",
"OtherMiddleName": null,
"OtherNamePrefix": null,
"OtherNameSuffix": null,
"OtherCredential": "REGISTERED NURSE",
"OtherLastNameTypeCode": "2",
"FirstLineMailingAddress": "149 FIELDVIEW DR",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "VERSAILLES",
"MailingAddressStateName": "KY",
"MailingAddressPostalCode": "40383-0836",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "859-492-7211",
"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "3775 BELLEAU WOOD DR",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "LEXINGTON",
"PracticeLocationAddressStateName": "KY",
"PracticeLocationAddressPostalCode": "40517-1804",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "859-271-9001",
"PracticeLocationAddressFaxNumber": null,
"EnumerationDate": "05/19/2025",
"LastUpdateDate": "05/19/2025",
"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": "163WG0000X",
"TaxonomyName": "General Practice Registered Nurse",
"LicenseNumber": "1070535",
"LicenseNumberStateCode": "KY",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}