{
"Npi": {
"NPI": "1861916728",
"EntityType": "Individual",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": "N",
"IsOrgSubpart": null,
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": null,
"LastName": "GYSBERS",
"FirstName": "ERIN",
"MiddleName": "MCLAIN",
"NamePrefix": "MRS.",
"NameSuffix": null,
"Credential": "MOT, OTR/L",
"OtherOrgName": null,
"OtherOrgNameTypeCode": null,
"OtherLastName": "MCLAIN",
"OtherFirstName": "ERIN",
"OtherMiddleName": "LYNN",
"OtherNamePrefix": "MISS",
"OtherNameSuffix": null,
"OtherCredential": "MOT, OTR/L",
"OtherLastNameTypeCode": "1",
"FirstLineMailingAddress": "121 S GARFIELD AVE STE A",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "TRAVERSE CITY",
"MailingAddressStateName": "MI",
"MailingAddressPostalCode": "49686-2967",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "231-735-1185",
"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "121 S GARFIELD AVE STE A",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "TRAVERSE CITY",
"PracticeLocationAddressStateName": "MI",
"PracticeLocationAddressPostalCode": "49686-2967",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "231-735-1185",
"PracticeLocationAddressFaxNumber": null,
"EnumerationDate": "08/01/2017",
"LastUpdateDate": "07/21/2022",
"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": "225X00000X",
"TaxonomyName": "Occupational Therapist",
"LicenseNumber": "5201007914",
"LicenseNumberStateCode": "MI",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}