{
"Npi": {
"NPI": "1578912960",
"EntityType": "Individual",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": "N",
"IsOrgSubpart": null,
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": null,
"LastName": "ISOM",
"FirstName": "HEATHER",
"MiddleName": null,
"NamePrefix": null,
"NameSuffix": null,
"Credential": null,
"OtherOrgName": null,
"OtherOrgNameTypeCode": null,
"OtherLastName": null,
"OtherFirstName": null,
"OtherMiddleName": null,
"OtherNamePrefix": null,
"OtherNameSuffix": null,
"OtherCredential": null,
"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "3921 ASHMORE DR",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "COLUMBUS",
"MailingAddressStateName": "GA",
"MailingAddressPostalCode": "31909-3809",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "706-570-3797",
"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "7101 HOFF ST",
"SecondLinePracticeLocationAddress": "BLDG 9240",
"PracticeLocationAddressCityName": "FT. BENNING",
"PracticeLocationAddressStateName": "GA",
"PracticeLocationAddressPostalCode": "31905",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "706-544-1148",
"PracticeLocationAddressFaxNumber": null,
"EnumerationDate": "06/07/2016",
"LastUpdateDate": "07/28/2021",
"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": "163W00000X",
"TaxonomyName": "Registered Nurse",
"LicenseNumber": "RN284749",
"LicenseNumberStateCode": "GA",
"PrimaryTaxonomySwitch": "N"
},
{
"TaxonomyCode": "124Q00000X",
"TaxonomyName": "Dental Hygienist",
"LicenseNumber": "DH012267",
"LicenseNumberStateCode": "GA",
"PrimaryTaxonomySwitch": "Y"
}
]
},
"HealthcareProviderTaxonomyGroups": null
}
}