{
"Npi": {
"NPI": "1952851479",
"EntityType": "Individual",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": "N",
"IsOrgSubpart": null,
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": null,
"LastName": "STEPHENS",
"FirstName": "TODD",
"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": "6700 WASHINGTON AVE S",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "EDEN PRAIRIE",
"MailingAddressStateName": "MN",
"MailingAddressPostalCode": "55344-3405",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "800-328-8602",
"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "4608 BROADWAY UNIT C",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "ALLENTOWN",
"PracticeLocationAddressStateName": "PA",
"PracticeLocationAddressPostalCode": "18104-3202",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "610-432-4155",
"PracticeLocationAddressFaxNumber": "610-432-9542",
"EnumerationDate": "10/07/2016",
"LastUpdateDate": "04/03/2019",
"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": "237600000X",
"TaxonomyName": "Audiologist-Hearing Aid Fitter",
"LicenseNumber": null,
"LicenseNumberStateCode": "PA",
"PrimaryTaxonomySwitch": "N"
},
{
"TaxonomyCode": "237700000X",
"TaxonomyName": "Hearing Instrument Specialist",
"LicenseNumber": null,
"LicenseNumberStateCode": null,
"PrimaryTaxonomySwitch": "Y"
}
]
},
"HealthcareProviderTaxonomyGroups": null
}
}