{
"Npi": {
"NPI": "1861210262",
"EntityType": "Individual",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": "N",
"IsOrgSubpart": null,
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": null,
"LastName": "VENABLE",
"FirstName": "RACHEL",
"MiddleName": "DAVENPORT",
"NamePrefix": null,
"NameSuffix": null,
"Credential": "COTA/L",
"OtherOrgName": null,
"OtherOrgNameTypeCode": null,
"OtherLastName": "DAVENPORT",
"OtherFirstName": "RACHEL",
"OtherMiddleName": "LAUREN",
"OtherNamePrefix": null,
"OtherNameSuffix": null,
"OtherCredential": null,
"OtherLastNameTypeCode": "1",
"FirstLineMailingAddress": "1949 BELLVIEW CHURCH RD",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "LAURENS",
"MailingAddressStateName": "SC",
"MailingAddressPostalCode": "29360-7019",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "864-981-4285",
"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "1650 GALISTEO ST",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "SANTA FE",
"PracticeLocationAddressStateName": "NM",
"PracticeLocationAddressPostalCode": "87505-4747",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "864-981-4285",
"PracticeLocationAddressFaxNumber": null,
"EnumerationDate": "10/03/2024",
"LastUpdateDate": "10/08/2024",
"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": "224Z00000X",
"TaxonomyName": "Occupational Therapy Assistant",
"LicenseNumber": "5403",
"LicenseNumberStateCode": "SC",
"PrimaryTaxonomySwitch": "N"
},
{
"TaxonomyCode": "224Z00000X",
"TaxonomyName": "Occupational Therapy Assistant",
"LicenseNumber": "OT-2023-0267",
"LicenseNumberStateCode": "NM",
"PrimaryTaxonomySwitch": "Y"
}
]
},
"HealthcareProviderTaxonomyGroups": null
}
}