{
"Npi": {
"NPI": "1699516526",
"EntityType": "Individual",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": "N",
"IsOrgSubpart": null,
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": null,
"LastName": "SCHRADER",
"FirstName": "THOMAS",
"MiddleName": null,
"NamePrefix": null,
"NameSuffix": null,
"Credential": null,
"OtherOrgName": null,
"OtherOrgNameTypeCode": null,
"OtherLastName": null,
"OtherFirstName": null,
"OtherMiddleName": null,
"OtherNamePrefix": null,
"OtherNameSuffix": null,
"OtherCredential": null,
"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "12141 STATE ROUTE 5 # 2",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "ASHLAND",
"MailingAddressStateName": "KY",
"MailingAddressPostalCode": "41102-8033",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": null,
"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "306 COMMERCE DR",
"SecondLinePracticeLocationAddress": "STE 700",
"PracticeLocationAddressCityName": "LOUISA",
"PracticeLocationAddressStateName": "KY",
"PracticeLocationAddressPostalCode": "41230-5065",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "606-638-7400",
"PracticeLocationAddressFaxNumber": null,
"EnumerationDate": "06/04/2024",
"LastUpdateDate": "06/04/2024",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": "M",
"Gender": "Male",
"AuthorizedOfficialLastName": null,
"AuthorizedOfficialFirstName": null,
"AuthorizedOfficialMiddleName": null,
"AuthorizedOfficialTitle": null,
"AuthorizedOfficialNamePrefix": null,
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": null,
"AuthorizedOfficialTelephoneNumber": null,
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "363L00000X",
"TaxonomyName": "Nurse Practitioner",
"LicenseNumber": "4022806",
"LicenseNumberStateCode": "KY",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}