{
"Npi": {
"NPI": "1679928451",
"EntityType": "Individual",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": "N",
"IsOrgSubpart": null,
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": null,
"LastName": "SWEET",
"FirstName": "DANIELLE",
"MiddleName": null,
"NamePrefix": null,
"NameSuffix": null,
"Credential": "PTA",
"OtherOrgName": null,
"OtherOrgNameTypeCode": null,
"OtherLastName": null,
"OtherFirstName": null,
"OtherMiddleName": null,
"OtherNamePrefix": null,
"OtherNameSuffix": null,
"OtherCredential": null,
"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "10560 OLD OLIVE STREET RD STE 100",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "CREVE COEUR",
"MailingAddressStateName": "MO",
"MailingAddressPostalCode": "63141-5928",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "314-567-4707",
"MailingAddressFaxNumber": "314-567-4505",
"FirstLinePracticeLocationAddress": "11364 FIVE OAKS PKWY",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "SAINT LOUIS",
"PracticeLocationAddressStateName": "MO",
"PracticeLocationAddressPostalCode": "63128-1405",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "314-210-9318",
"PracticeLocationAddressFaxNumber": null,
"EnumerationDate": "04/28/2016",
"LastUpdateDate": "05/08/2024",
"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": "225200000X",
"TaxonomyName": "Physical Therapy Assistant",
"LicenseNumber": "2015036953",
"LicenseNumberStateCode": "MO",
"PrimaryTaxonomySwitch": "N"
},
{
"TaxonomyCode": "222Q00000X",
"TaxonomyName": "Developmental Therapist",
"LicenseNumber": null,
"LicenseNumberStateCode": null,
"PrimaryTaxonomySwitch": "Y"
}
]
},
"HealthcareProviderTaxonomyGroups": null
}
}