{
"Npi": {
"NPI": "1861644064",
"EntityType": "Individual",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": "N",
"IsOrgSubpart": null,
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": null,
"LastName": "BAIRD",
"FirstName": "TERESA",
"MiddleName": null,
"NamePrefix": null,
"NameSuffix": null,
"Credential": "O.T.",
"OtherOrgName": null,
"OtherOrgNameTypeCode": null,
"OtherLastName": null,
"OtherFirstName": null,
"OtherMiddleName": null,
"OtherNamePrefix": null,
"OtherNameSuffix": null,
"OtherCredential": null,
"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "118 MEDICAL DRIVE",
"SecondLineMailingAddress": "LIFESPAN THERAPY",
"MailingAddressCityName": "CARMEL",
"MailingAddressStateName": "IN",
"MailingAddressPostalCode": "46032",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "317-573-1037",
"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "725 BELL TRACE CIRCLE",
"SecondLinePracticeLocationAddress": "BELL TRACE HEALTH & LIVING COMMUNITY",
"PracticeLocationAddressCityName": "BLOOMINGTON",
"PracticeLocationAddressStateName": "IN",
"PracticeLocationAddressPostalCode": "47408-4408",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "812-323-2858",
"PracticeLocationAddressFaxNumber": null,
"EnumerationDate": "10/21/2008",
"LastUpdateDate": "10/21/2008",
"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": "225X00000X",
"TaxonomyName": "Occupational Therapist",
"LicenseNumber": "31003629A",
"LicenseNumberStateCode": "IN",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}