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1558072108 NPI number — CAROLINE SMITH GHEE PA-C

NPI Number: 1558072108
Health Care Provider/Practitioner: CAROLINE SMITH GHEE PA-C

Information about “1558072108” NPI (CAROLINE SMITH GHEE PA-C) exists in 1558072108 in HTML format HTML  |  1558072108 in plain Text format TXT  |  1558072108 in PDF (Portable Document Format) PDF  |  1558072108 in an XML format XML  formats.

NPI Number : 1558072108 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1558072108",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "N",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "GHEE",
    "FirstName": "CAROLINE",
    "MiddleName": "SMITH",
    "NamePrefix": null,
    "NameSuffix": null,
    "Credential": "PA-C",
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": "SMITH",
    "OtherFirstName": "CAROLINE",
    "OtherMiddleName": "ALEXANDRA",
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": "PA-C",
    "OtherLastNameTypeCode": "1",
    "FirstLineMailingAddress": "766 LAKE COLONY TRL",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "VESTAVIA",
    "MailingAddressStateName": "AL",
    "MailingAddressPostalCode": "35242-7400",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "205-276-0885",
    "MailingAddressFaxNumber": null,
    "FirstLinePracticeLocationAddress": "32 CHURCH ST",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "MOUNTAIN BRK",
    "PracticeLocationAddressStateName": "AL",
    "PracticeLocationAddressPostalCode": "35213-3702",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "205-276-0885",
    "PracticeLocationAddressFaxNumber": null,
    "EnumerationDate": "12/05/2022",
    "LastUpdateDate": "02/20/2025",
    "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": "363A00000X",
          "TaxonomyName": "Physician Assistant",
          "LicenseNumber": "PA200002073",
          "LicenseNumberStateCode": "DC",
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "363A00000X",
          "TaxonomyName": "Physician Assistant",
          "LicenseNumber": "1975",
          "LicenseNumberStateCode": "AL",
          "PrimaryTaxonomySwitch": "Y"
        }
      ]
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

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