{
"Npi": {
"NPI": "1780569020",
"EntityType": "Individual",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": "Y",
"IsOrgSubpart": null,
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": null,
"LastName": "SPEED-HENLEY",
"FirstName": "CAMERON",
"MiddleName": null,
"NamePrefix": null,
"NameSuffix": null,
"Credential": "BCTMB, LMT, CMLDT",
"OtherOrgName": null,
"OtherOrgNameTypeCode": null,
"OtherLastName": null,
"OtherFirstName": null,
"OtherMiddleName": null,
"OtherNamePrefix": null,
"OtherNameSuffix": null,
"OtherCredential": null,
"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "912 DARTMOUTH WOODS DR",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "DARTMOUTH",
"MailingAddressStateName": "MA",
"MailingAddressPostalCode": "02747-5123",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "508-426-9180",
"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "49 STATE RD",
"SecondLinePracticeLocationAddress": "WATUPPA BLDG, #101",
"PracticeLocationAddressCityName": "NORTH DARTMOUTH",
"PracticeLocationAddressStateName": "MA",
"PracticeLocationAddressPostalCode": "02747",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "508-426-9180",
"PracticeLocationAddressFaxNumber": null,
"EnumerationDate": "08/06/2025",
"LastUpdateDate": "08/06/2025",
"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": "225700000X",
"TaxonomyName": "Massage Therapist",
"LicenseNumber": "MT125330",
"LicenseNumberStateCode": "TX",
"PrimaryTaxonomySwitch": "N"
},
{
"TaxonomyCode": "225700000X",
"TaxonomyName": "Massage Therapist",
"LicenseNumber": "MT02918",
"LicenseNumberStateCode": "RI",
"PrimaryTaxonomySwitch": "N"
},
{
"TaxonomyCode": "225700000X",
"TaxonomyName": "Massage Therapist",
"LicenseNumber": "18265",
"LicenseNumberStateCode": "MA",
"PrimaryTaxonomySwitch": "Y"
}
]
},
"HealthcareProviderTaxonomyGroups": null
}
}