{
"Npi": {
"NPI": "1780090894",
"EntityType": "Individual",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": "N",
"IsOrgSubpart": null,
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": null,
"LastName": "SULLIVAN TANSEY",
"FirstName": "MARY HEATHER",
"MiddleName": null,
"NamePrefix": null,
"NameSuffix": null,
"Credential": "MT",
"OtherOrgName": null,
"OtherOrgNameTypeCode": null,
"OtherLastName": null,
"OtherFirstName": null,
"OtherMiddleName": null,
"OtherNamePrefix": null,
"OtherNameSuffix": null,
"OtherCredential": null,
"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "30138 N 121ST LN",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "PEORIA",
"MailingAddressStateName": "AZ",
"MailingAddressPostalCode": "85383-3489",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "909-844-1326",
"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "8996 W UNION HILLS DR",
"SecondLinePracticeLocationAddress": "#103",
"PracticeLocationAddressCityName": "PEORIA",
"PracticeLocationAddressStateName": "AZ",
"PracticeLocationAddressPostalCode": "85382-3010",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "909-844-1326",
"PracticeLocationAddressFaxNumber": null,
"EnumerationDate": "07/09/2014",
"LastUpdateDate": "07/09/2014",
"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": "225700000X",
"TaxonomyName": "Massage Therapist",
"LicenseNumber": "#MT-18093",
"LicenseNumberStateCode": "AZ",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}