{
"Npi": {
"NPI": "1902221385",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "THERAPEUTIC & PAIN MANAGEMENT MASSAGE THERAPY",
"LastName": null,
"FirstName": null,
"MiddleName": null,
"NamePrefix": null,
"NameSuffix": null,
"Credential": null,
"OtherOrgName": null,
"OtherOrgNameTypeCode": null,
"OtherLastName": null,
"OtherFirstName": null,
"OtherMiddleName": null,
"OtherNamePrefix": null,
"OtherNameSuffix": null,
"OtherCredential": null,
"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "105 ROBINS WAY",
"SecondLineMailingAddress": "SUITE 204",
"MailingAddressCityName": "RUSSELLVILLE",
"MailingAddressStateName": "KY",
"MailingAddressPostalCode": "42276-1129",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "270-893-8706",
"MailingAddressFaxNumber": "888-704-8506",
"FirstLinePracticeLocationAddress": "105 ROBINS WAY",
"SecondLinePracticeLocationAddress": "SUITE 204",
"PracticeLocationAddressCityName": "RUSSELLVILLE",
"PracticeLocationAddressStateName": "KY",
"PracticeLocationAddressPostalCode": "42276-1129",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "270-893-8706",
"PracticeLocationAddressFaxNumber": "888-704-8506",
"EnumerationDate": "02/21/2014",
"LastUpdateDate": "10/30/2014",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "HANKINS",
"AuthorizedOfficialFirstName": "REBECCA",
"AuthorizedOfficialMiddleName": "E.",
"AuthorizedOfficialTitle": "MASSAGE THERAPIST/OWNER",
"AuthorizedOfficialNamePrefix": "MRS.",
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "LMT, MMP",
"AuthorizedOfficialTelephoneNumber": "270-893-8706",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "225700000X",
"TaxonomyName": "Massage Therapist",
"LicenseNumber": "KY-3935",
"LicenseNumberStateCode": "KY",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": {
"HealthcareProviderTaxonomyGroup": {
"HealthcareProviderTaxonomyGroupName": "193400000X SINGLE SPECIALTY GROUP",
"HealthcareProviderTaxonomyGroupDescription": "Single Specialty Group - A business group of one or more individual practitioners, all of who practice with the same area of specialization."
}
}
}
}