{
"Npi": {
"NPI": "1598925364",
"EntityType": "Individual",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": "N",
"IsOrgSubpart": null,
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": null,
"LastName": "SANGCHANINTRA",
"FirstName": "SRISAKULA",
"MiddleName": null,
"NamePrefix": null,
"NameSuffix": null,
"Credential": null,
"OtherOrgName": null,
"OtherOrgNameTypeCode": null,
"OtherLastName": "LADADOK",
"OtherFirstName": "SRISAKULA",
"OtherMiddleName": "SANGCHANINTRA",
"OtherNamePrefix": null,
"OtherNameSuffix": null,
"OtherCredential": null,
"OtherLastNameTypeCode": "1",
"FirstLineMailingAddress": "510 WOODWARD RD",
"SecondLineMailingAddress": "FIRST FL.",
"MailingAddressCityName": "N PROVIDENCE",
"MailingAddressStateName": "RI",
"MailingAddressPostalCode": "02904-4719",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "401-709-4240",
"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "200 HIGH SERVICE AVE",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "N PROVIDENCE",
"PracticeLocationAddressStateName": "RI",
"PracticeLocationAddressPostalCode": "02904-5113",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "401-456-3638",
"PracticeLocationAddressFaxNumber": null,
"EnumerationDate": "06/14/2008",
"LastUpdateDate": "06/14/2008",
"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": "367500000X",
"TaxonomyName": "Certified Registered Nurse Anesthetist",
"LicenseNumber": "RNA36677",
"LicenseNumberStateCode": "RI",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}