{
"Npi": {
"NPI": "1679721039",
"EntityType": "Individual",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": "Y",
"IsOrgSubpart": null,
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": null,
"LastName": "WHITE",
"FirstName": "SHUNAKA",
"MiddleName": "GRAYSON",
"NamePrefix": "MRS.",
"NameSuffix": null,
"Credential": "OTR/L, CAPS, ECHM",
"OtherOrgName": null,
"OtherOrgNameTypeCode": null,
"OtherLastName": "GRAYSON",
"OtherFirstName": "SHUNAKA",
"OtherMiddleName": "TRENISE",
"OtherNamePrefix": "MS.",
"OtherNameSuffix": null,
"OtherCredential": "OTR/L, CAPS, ECHM",
"OtherLastNameTypeCode": "5",
"FirstLineMailingAddress": "532 GLADIOLA WAY",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "STAFFORD",
"MailingAddressStateName": "VA",
"MailingAddressPostalCode": "22554-6848",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "202-696-0634",
"MailingAddressFaxNumber": "540-657-3664",
"FirstLinePracticeLocationAddress": "532 GLADIOLA WAY",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "STAFFORD",
"PracticeLocationAddressStateName": "VA",
"PracticeLocationAddressPostalCode": "22554-6848",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "202-696-0634",
"PracticeLocationAddressFaxNumber": "540-657-3664",
"EnumerationDate": "08/28/2008",
"LastUpdateDate": "03/22/2025",
"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": "225X00000X",
"TaxonomyName": "Occupational Therapist",
"LicenseNumber": "0119006450",
"LicenseNumberStateCode": "VA",
"PrimaryTaxonomySwitch": "Y"
},
{
"TaxonomyCode": "225X00000X",
"TaxonomyName": "Occupational Therapist",
"LicenseNumber": "3551",
"LicenseNumberStateCode": "TN",
"PrimaryTaxonomySwitch": "N"
}
]
},
"HealthcareProviderTaxonomyGroups": null
}
}