{
"Npi": {
"NPI": "1609354331",
"EntityType": "Individual",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": "N",
"IsOrgSubpart": null,
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": null,
"LastName": "SMITH",
"FirstName": "STACY",
"MiddleName": "B",
"NamePrefix": null,
"NameSuffix": null,
"Credential": "PT",
"OtherOrgName": null,
"OtherOrgNameTypeCode": null,
"OtherLastName": "BARRINGER",
"OtherFirstName": "STACY",
"OtherMiddleName": null,
"OtherNamePrefix": null,
"OtherNameSuffix": null,
"OtherCredential": "PT",
"OtherLastNameTypeCode": "1",
"FirstLineMailingAddress": "3300 RIVERMONT AVE",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "LYNCHBURG",
"MailingAddressStateName": "VA",
"MailingAddressPostalCode": "24503-2030",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "434-200-5032",
"MailingAddressFaxNumber": "434-200-3003",
"FirstLinePracticeLocationAddress": "3300 RIVERMONT AVE",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "LYNCHBURG",
"PracticeLocationAddressStateName": "VA",
"PracticeLocationAddressPostalCode": "24503-2030",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "434-200-5032",
"PracticeLocationAddressFaxNumber": "434-200-3003",
"EnumerationDate": "08/03/2018",
"LastUpdateDate": "08/03/2018",
"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": "225100000X",
"TaxonomyName": "Physical Therapist",
"LicenseNumber": "2305212233",
"LicenseNumberStateCode": "VA",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}