{
"Npi": {
"NPI": "1942272992",
"EntityType": "Individual",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": "N",
"IsOrgSubpart": null,
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": null,
"LastName": "HATFIELD",
"FirstName": "BOBBY",
"MiddleName": "BOYD",
"NamePrefix": null,
"NameSuffix": "JR.",
"Credential": "PHD, HSPP",
"OtherOrgName": null,
"OtherOrgNameTypeCode": null,
"OtherLastName": null,
"OtherFirstName": null,
"OtherMiddleName": null,
"OtherNamePrefix": null,
"OtherNameSuffix": null,
"OtherCredential": null,
"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "8711 S COUNTY ROAD 600 E STE A",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "SELMA",
"MailingAddressStateName": "IN",
"MailingAddressPostalCode": "47383-9338",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "765-730-2649",
"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "8711 S COUNTY ROAD 600 E",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "SELMA",
"PracticeLocationAddressStateName": "IN",
"PracticeLocationAddressPostalCode": "47383-9338",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "765-730-2649",
"PracticeLocationAddressFaxNumber": null,
"EnumerationDate": "02/03/2006",
"LastUpdateDate": "06/14/2019",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": "M",
"Gender": "Male",
"AuthorizedOfficialLastName": null,
"AuthorizedOfficialFirstName": null,
"AuthorizedOfficialMiddleName": null,
"AuthorizedOfficialTitle": null,
"AuthorizedOfficialNamePrefix": null,
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": null,
"AuthorizedOfficialTelephoneNumber": null,
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "103G00000X",
"TaxonomyName": "Clinical Neuropsychologist",
"LicenseNumber": "20041571A",
"LicenseNumberStateCode": "IN",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}