{
"Npi": {
"NPI": "1558255471",
"EntityType": "Individual",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": "Y",
"IsOrgSubpart": null,
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": null,
"LastName": "IRISH",
"FirstName": "SAMANTHA",
"MiddleName": null,
"NamePrefix": null,
"NameSuffix": null,
"Credential": "CPED",
"OtherOrgName": null,
"OtherOrgNameTypeCode": null,
"OtherLastName": null,
"OtherFirstName": null,
"OtherMiddleName": null,
"OtherNamePrefix": null,
"OtherNameSuffix": null,
"OtherCredential": null,
"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "10563 E CAROLINA WILLOW LN",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "TUCSON",
"MailingAddressStateName": "AZ",
"MailingAddressPostalCode": "85747-9538",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "520-990-5728",
"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "8050 E GERMANN RD",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "MESA",
"PracticeLocationAddressStateName": "AZ",
"PracticeLocationAddressPostalCode": "85212",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "520-990-5728",
"PracticeLocationAddressFaxNumber": null,
"EnumerationDate": "06/05/2025",
"LastUpdateDate": "06/05/2025",
"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": "224L00000X",
"TaxonomyName": "Pedorthist",
"LicenseNumber": "CPED4668",
"LicenseNumberStateCode": "AZ",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}