{
"Npi": {
"NPI": "1619328663",
"EntityType": "Individual",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": "Y",
"IsOrgSubpart": null,
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": null,
"LastName": "GARCIA",
"FirstName": "NATHIFA",
"MiddleName": "AISHA",
"NamePrefix": "MS.",
"NameSuffix": null,
"Credential": "APN",
"OtherOrgName": null,
"OtherOrgNameTypeCode": null,
"OtherLastName": "ST JOHN",
"OtherFirstName": "NATHIFA",
"OtherMiddleName": "AISHA",
"OtherNamePrefix": null,
"OtherNameSuffix": null,
"OtherCredential": null,
"OtherLastNameTypeCode": "1",
"FirstLineMailingAddress": "301 LIPPINCOTT DR STE 410",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "MARLTON",
"MailingAddressStateName": "NJ",
"MailingAddressPostalCode": "08053-4197",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "856-355-0340",
"MailingAddressFaxNumber": "856-355-0330",
"FirstLinePracticeLocationAddress": "1601 HADDON AVE # A",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "CAMDEN",
"PracticeLocationAddressStateName": "NJ",
"PracticeLocationAddressPostalCode": "08103-3109",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "856-757-3840",
"PracticeLocationAddressFaxNumber": null,
"EnumerationDate": "06/30/2016",
"LastUpdateDate": "12/23/2025",
"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": "363L00000X",
"TaxonomyName": "Nurse Practitioner",
"LicenseNumber": "26NJ00624800",
"LicenseNumberStateCode": "NJ",
"PrimaryTaxonomySwitch": "Y"
},
{
"TaxonomyCode": "261QA1903X",
"TaxonomyName": "Ambulatory Surgical Clinic/Center",
"LicenseNumber": "223361862",
"LicenseNumberStateCode": "NJ",
"PrimaryTaxonomySwitch": "N"
}
]
},
"HealthcareProviderTaxonomyGroups": {
"HealthcareProviderTaxonomyGroup": {
"HealthcareProviderTaxonomyGroupName": "193200000X MULTI-SPECIALTY GROUP",
"HealthcareProviderTaxonomyGroupDescription": "Multi-Specialty Group - A business group of one or more individual practitioners, who practice with different areas of specialization."
}
}
}
}