{
"Npi": {
"NPI": "1679754923",
"EntityType": "Individual",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": "N",
"IsOrgSubpart": null,
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": null,
"LastName": "DOOLEY",
"FirstName": "MICHELLE",
"MiddleName": null,
"NamePrefix": null,
"NameSuffix": null,
"Credential": "RPH, LMT",
"OtherOrgName": null,
"OtherOrgNameTypeCode": null,
"OtherLastName": "BOWLER",
"OtherFirstName": "MICHELLE",
"OtherMiddleName": null,
"OtherNamePrefix": null,
"OtherNameSuffix": null,
"OtherCredential": "RPH",
"OtherLastNameTypeCode": "1",
"FirstLineMailingAddress": "1215 LOGGER HEAD CIRCLE",
"SecondLineMailingAddress": "UNIT 203",
"MailingAddressCityName": "DAVENPORT",
"MailingAddressStateName": "FL",
"MailingAddressPostalCode": "33896",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "315-955-5403",
"MailingAddressFaxNumber": "315-955-5403",
"FirstLinePracticeLocationAddress": "50 N MAIN ST",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "ELLENVILLE",
"PracticeLocationAddressStateName": "NY",
"PracticeLocationAddressPostalCode": "12428-1015",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "845-647-8507",
"PracticeLocationAddressFaxNumber": "845-647-8538",
"EnumerationDate": "11/15/2007",
"LastUpdateDate": "10/09/2025",
"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": "183500000X",
"TaxonomyName": "Pharmacist",
"LicenseNumber": "045510",
"LicenseNumberStateCode": "NY",
"PrimaryTaxonomySwitch": "Y"
},
{
"TaxonomyCode": "225700000X",
"TaxonomyName": "Massage Therapist",
"LicenseNumber": "MA108260",
"LicenseNumberStateCode": "FL",
"PrimaryTaxonomySwitch": "N"
}
]
},
"HealthcareProviderTaxonomyGroups": null
}
}