{
"Npi": {
"NPI": "1548686876",
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"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": "N",
"IsOrgSubpart": null,
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": null,
"LastName": "LONGORIA",
"FirstName": "LISA",
"MiddleName": "MARIE",
"NamePrefix": "MRS.",
"NameSuffix": "I",
"Credential": null,
"OtherOrgName": null,
"OtherOrgNameTypeCode": null,
"OtherLastName": "SPENCER",
"OtherFirstName": "LISA",
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"OtherNamePrefix": null,
"OtherNameSuffix": null,
"OtherCredential": "MASSAGE THERAPIST",
"OtherLastNameTypeCode": "1",
"FirstLineMailingAddress": "17165 BAILEY RD",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "BAILEY",
"MailingAddressStateName": "MI",
"MailingAddressPostalCode": "49303-9729",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "616-914-7362",
"MailingAddressFaxNumber": "231-282-7057",
"FirstLinePracticeLocationAddress": "17615 BAILEY RD",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "BAILEY",
"PracticeLocationAddressStateName": "MI",
"PracticeLocationAddressPostalCode": "49303-9729",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "616-914-7362",
"PracticeLocationAddressFaxNumber": "231-282-7057",
"EnumerationDate": "03/11/2014",
"LastUpdateDate": "03/11/2014",
"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": "225700000X",
"TaxonomyName": "Massage Therapist",
"LicenseNumber": "7501002188",
"LicenseNumberStateCode": "MI",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}