{
"Npi": {
"NPI": "1821634395",
"EntityType": "Individual",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": "N",
"IsOrgSubpart": null,
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": null,
"LastName": "HILL",
"FirstName": "SHYKITA",
"MiddleName": "EDGERTON",
"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": "200 E 2ND AVE",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "GASTONIA",
"MailingAddressStateName": "NC",
"MailingAddressPostalCode": "28052-4358",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "704-874-9005",
"MailingAddressFaxNumber": "704-939-1173",
"FirstLinePracticeLocationAddress": "766 HARTNESS RD STE A",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "STATESVILLE",
"PracticeLocationAddressStateName": "NC",
"PracticeLocationAddressPostalCode": "28677-3485",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "704-380-3620",
"PracticeLocationAddressFaxNumber": null,
"EnumerationDate": "11/20/2019",
"LastUpdateDate": "07/29/2022",
"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": "1041C0700X",
"TaxonomyName": "Clinical Social Worker",
"LicenseNumber": "P014260",
"LicenseNumberStateCode": "NC",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}