{
"Npi": {
"NPI": "1760365688",
"EntityType": "Individual",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": "Y",
"IsOrgSubpart": null,
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": null,
"LastName": "SIBERT",
"FirstName": "JENNIFER",
"MiddleName": "L",
"NamePrefix": null,
"NameSuffix": null,
"Credential": null,
"OtherOrgName": null,
"OtherOrgNameTypeCode": null,
"OtherLastName": "CANOY",
"OtherFirstName": "JENNIFER",
"OtherMiddleName": "L",
"OtherNamePrefix": null,
"OtherNameSuffix": null,
"OtherCredential": null,
"OtherLastNameTypeCode": "1",
"FirstLineMailingAddress": "PO BOX 701254",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "PLYMOUTH",
"MailingAddressStateName": "MI",
"MailingAddressPostalCode": "48170-0961",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "248-910-7396",
"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "12806 ROYAL GRAND",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "REDFORD",
"PracticeLocationAddressStateName": "MI",
"PracticeLocationAddressPostalCode": "48239-2667",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "248-910-7396",
"PracticeLocationAddressFaxNumber": "248-910-7396",
"EnumerationDate": "07/29/2025",
"LastUpdateDate": "07/29/2025",
"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": "372500000X",
"TaxonomyName": "Chore Provider",
"LicenseNumber": null,
"LicenseNumberStateCode": null,
"PrimaryTaxonomySwitch": "N"
},
{
"TaxonomyCode": "372600000X",
"TaxonomyName": "Adult Companion",
"LicenseNumber": null,
"LicenseNumberStateCode": null,
"PrimaryTaxonomySwitch": "N"
},
{
"TaxonomyCode": "253Z00000X",
"TaxonomyName": "In Home Supportive Care Agency",
"LicenseNumber": null,
"LicenseNumberStateCode": null,
"PrimaryTaxonomySwitch": "Y"
}
]
},
"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."
}
}
}
}