{
"Npi": {
"NPI": "1598313777",
"EntityType": "Individual",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": "Y",
"IsOrgSubpart": null,
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": null,
"LastName": "BROWN",
"FirstName": "JAKEMMA",
"MiddleName": "MCDANIEL",
"NamePrefix": "MS.",
"NameSuffix": null,
"Credential": "SLP",
"OtherOrgName": null,
"OtherOrgNameTypeCode": null,
"OtherLastName": "MCDANIEL",
"OtherFirstName": "JAKEMMA",
"OtherMiddleName": "LASHANEK",
"OtherNamePrefix": null,
"OtherNameSuffix": null,
"OtherCredential": "SLPA",
"OtherLastNameTypeCode": "1",
"FirstLineMailingAddress": "114 FALLS STREET",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "BLACKSBURG",
"MailingAddressStateName": "SC",
"MailingAddressPostalCode": "29702",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "704-240-7406",
"MailingAddressFaxNumber": "866-897-4727",
"FirstLinePracticeLocationAddress": "114 FALLS STREET",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "BLACKSBURG",
"PracticeLocationAddressStateName": "SC",
"PracticeLocationAddressPostalCode": "29702",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "803-203-2864",
"PracticeLocationAddressFaxNumber": "866-897-4727",
"EnumerationDate": "08/30/2019",
"LastUpdateDate": "01/20/2023",
"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": "2355S0801X",
"TaxonomyName": "Speech-Language Assistant",
"LicenseNumber": "5755",
"LicenseNumberStateCode": "SC",
"PrimaryTaxonomySwitch": "N"
},
{
"TaxonomyCode": "235Z00000X",
"TaxonomyName": "Speech-Language Pathologist",
"LicenseNumber": "5755",
"LicenseNumberStateCode": "SC",
"PrimaryTaxonomySwitch": "Y"
}
]
},
"HealthcareProviderTaxonomyGroups": null
}
}