{
"Npi": {
"NPI": "1891818555",
"EntityType": "Individual",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": "Y",
"IsOrgSubpart": null,
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": null,
"LastName": "TATE",
"FirstName": "ANGELA",
"MiddleName": "GAIL",
"NamePrefix": "MS.",
"NameSuffix": null,
"Credential": "MCD/CCC-SLP",
"OtherOrgName": null,
"OtherOrgNameTypeCode": null,
"OtherLastName": "TATE-WASHINGTON",
"OtherFirstName": "ANGELA",
"OtherMiddleName": "GAIL",
"OtherNamePrefix": "MS.",
"OtherNameSuffix": null,
"OtherCredential": "MCD/CCC-SLP",
"OtherLastNameTypeCode": "1",
"FirstLineMailingAddress": "3400 MCCLURE BRIDGE RD G 701",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "DULUTH",
"MailingAddressStateName": "GA",
"MailingAddressPostalCode": "30096-8751",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "678-957-1012",
"MailingAddressFaxNumber": "678-957-1013",
"FirstLinePracticeLocationAddress": "3400 MCCLURE BRIDGE RD G 701",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "DULUTH",
"PracticeLocationAddressStateName": "GA",
"PracticeLocationAddressPostalCode": "30096-8751",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "678-957-1012",
"PracticeLocationAddressFaxNumber": "678-957-1013",
"EnumerationDate": "04/09/2007",
"LastUpdateDate": "06/17/2016",
"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": "235Z00000X",
"TaxonomyName": "Speech-Language Pathologist",
"LicenseNumber": "SLP 5334",
"LicenseNumberStateCode": "AZ",
"PrimaryTaxonomySwitch": "N"
},
{
"TaxonomyCode": "235Z00000X",
"TaxonomyName": "Speech-Language Pathologist",
"LicenseNumber": "006491",
"LicenseNumberStateCode": "GA",
"PrimaryTaxonomySwitch": "N"
},
{
"TaxonomyCode": "235Z00000X",
"TaxonomyName": "Speech-Language Pathologist",
"LicenseNumber": "SLP006491",
"LicenseNumberStateCode": "GA",
"PrimaryTaxonomySwitch": "Y"
}
]
},
"HealthcareProviderTaxonomyGroups": null
}
}