{
"Npi": {
"NPI": "1902002652",
"EntityType": "Individual",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": "N",
"IsOrgSubpart": null,
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": null,
"LastName": "OTTOPAL",
"FirstName": "CARRIE",
"MiddleName": "ANN",
"NamePrefix": "MRS.",
"NameSuffix": null,
"Credential": "A.T.C.",
"OtherOrgName": null,
"OtherOrgNameTypeCode": null,
"OtherLastName": "OTTE",
"OtherFirstName": "CARRIE",
"OtherMiddleName": "ANN",
"OtherNamePrefix": "MISS",
"OtherNameSuffix": null,
"OtherCredential": "A.T.C.",
"OtherLastNameTypeCode": "1",
"FirstLineMailingAddress": "7580 LAKE POINTE",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "MAINEVILLE",
"MailingAddressStateName": "OH",
"MailingAddressPostalCode": "45039-8464",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "513-225-5610",
"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "6200 PFEIFFER RD",
"SecondLinePracticeLocationAddress": "#370",
"PracticeLocationAddressCityName": "CINCINNATI",
"PracticeLocationAddressStateName": "OH",
"PracticeLocationAddressPostalCode": "45242-5862",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "513-985-6750",
"PracticeLocationAddressFaxNumber": null,
"EnumerationDate": "06/21/2007",
"LastUpdateDate": "07/08/2007",
"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": "2255A2300X",
"TaxonomyName": "Athletic Trainer",
"LicenseNumber": "002010",
"LicenseNumberStateCode": "OH",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}