{
"Npi": {
"NPI": "1912350513",
"EntityType": "Individual",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": "N",
"IsOrgSubpart": null,
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": null,
"LastName": "THACKER",
"FirstName": "MELODEE",
"MiddleName": "B",
"NamePrefix": null,
"NameSuffix": null,
"Credential": "APRN",
"OtherOrgName": null,
"OtherOrgNameTypeCode": null,
"OtherLastName": null,
"OtherFirstName": null,
"OtherMiddleName": null,
"OtherNamePrefix": null,
"OtherNameSuffix": null,
"OtherCredential": null,
"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "5900 ROUTE US 60 W SUITE B",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "ASHLAND",
"MailingAddressStateName": "KY",
"MailingAddressPostalCode": "41102",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "606-393-5586",
"MailingAddressFaxNumber": "606-928-5547",
"FirstLinePracticeLocationAddress": "5900 ROUTE US 60 W SUITE B",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "ASHLAND",
"PracticeLocationAddressStateName": "KY",
"PracticeLocationAddressPostalCode": "41102",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "606-393-5586",
"PracticeLocationAddressFaxNumber": "606-928-5547",
"EnumerationDate": "07/19/2016",
"LastUpdateDate": "11/19/2020",
"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": "364SP0809X",
"TaxonomyName": "Adult Psychiatric/Mental Health Clinical Nurse Specialist",
"LicenseNumber": "APRN.CNP.020075",
"LicenseNumberStateCode": "OH",
"PrimaryTaxonomySwitch": "N"
},
{
"TaxonomyCode": "2084P0800X",
"TaxonomyName": "Psychiatry Physician",
"LicenseNumber": "1145293",
"LicenseNumberStateCode": "KY",
"PrimaryTaxonomySwitch": "Y"
}
]
},
"HealthcareProviderTaxonomyGroups": null
}
}