{
"Npi": {
"NPI": "1801005970",
"EntityType": "Individual",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": "N",
"IsOrgSubpart": null,
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": null,
"LastName": "DAVIS",
"FirstName": "CAROLYN",
"MiddleName": "CUPPS",
"NamePrefix": "DR.",
"NameSuffix": null,
"Credential": "MD PHD",
"OtherOrgName": null,
"OtherOrgNameTypeCode": null,
"OtherLastName": "LOBUE",
"OtherFirstName": "CAROLYN",
"OtherMiddleName": "CUPPS",
"OtherNamePrefix": "MRS.",
"OtherNameSuffix": null,
"OtherCredential": "PHD",
"OtherLastNameTypeCode": "1",
"FirstLineMailingAddress": "PO BOX 2653",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "CARMICHAEL",
"MailingAddressStateName": "CA",
"MailingAddressPostalCode": "95609-2653",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "916-482-1345",
"MailingAddressFaxNumber": "916-488-0284",
"FirstLinePracticeLocationAddress": "2864 EL PRADO WAY",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "SACRAMENTO",
"PracticeLocationAddressStateName": "CA",
"PracticeLocationAddressPostalCode": "95825-1835",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "916-482-1345",
"PracticeLocationAddressFaxNumber": "916-488-0284",
"EnumerationDate": "05/22/2007",
"LastUpdateDate": "07/08/2007",
"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": "207V00000X",
"TaxonomyName": "Obstetrics & Gynecology Physician",
"LicenseNumber": "G32758",
"LicenseNumberStateCode": "CA",
"PrimaryTaxonomySwitch": "Y"
},
{
"TaxonomyCode": "207V00000X",
"TaxonomyName": "Obstetrics & Gynecology Physician",
"LicenseNumber": "MD00017810",
"LicenseNumberStateCode": "WA",
"PrimaryTaxonomySwitch": "N"
}
]
},
"HealthcareProviderTaxonomyGroups": null
}
}