{
"Npi": {
"NPI": "1548785447",
"EntityType": "Individual",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": "N",
"IsOrgSubpart": null,
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": null,
"LastName": "GIPE",
"FirstName": "KRISTEN",
"MiddleName": "ANNE",
"NamePrefix": "MRS.",
"NameSuffix": null,
"Credential": "PTA",
"OtherOrgName": null,
"OtherOrgNameTypeCode": null,
"OtherLastName": "FENTON",
"OtherFirstName": "KRISTEN",
"OtherMiddleName": "ANNE",
"OtherNamePrefix": null,
"OtherNameSuffix": null,
"OtherCredential": null,
"OtherLastNameTypeCode": "1",
"FirstLineMailingAddress": "2428 VALLEY VIEW LN",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "NEW PHILADELPHIA",
"MailingAddressStateName": "OH",
"MailingAddressPostalCode": "44663-8851",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": null,
"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "245 S BROADWAY ST # 251",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "NEW PHILADELPHIA",
"PracticeLocationAddressStateName": "OH",
"PracticeLocationAddressPostalCode": "44663-3842",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "330-275-3744",
"PracticeLocationAddressFaxNumber": null,
"EnumerationDate": "08/11/2017",
"LastUpdateDate": "06/16/2018",
"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": "225200000X",
"TaxonomyName": "Physical Therapy Assistant",
"LicenseNumber": "09087",
"LicenseNumberStateCode": "OH",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}