{
"Npi": {
"NPI": "1952908204",
"EntityType": "Individual",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": "N",
"IsOrgSubpart": null,
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": null,
"LastName": "MEZZETTI",
"FirstName": "KIMBERLY",
"MiddleName": null,
"NamePrefix": null,
"NameSuffix": null,
"Credential": "RDN, LDN",
"OtherOrgName": null,
"OtherOrgNameTypeCode": null,
"OtherLastName": null,
"OtherFirstName": null,
"OtherMiddleName": null,
"OtherNamePrefix": null,
"OtherNameSuffix": null,
"OtherCredential": null,
"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "1439 S LADERA TER",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "INVERNESS",
"MailingAddressStateName": "FL",
"MailingAddressPostalCode": "34452-3631",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "561-654-6534",
"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "4826 SW 49TH RD",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "OCALA",
"PracticeLocationAddressStateName": "FL",
"PracticeLocationAddressPostalCode": "34474-6299",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "561-654-6534",
"PracticeLocationAddressFaxNumber": null,
"EnumerationDate": "10/08/2020",
"LastUpdateDate": "11/01/2023",
"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": "133NN1002X",
"TaxonomyName": "Nutrition Education Nutritionist",
"LicenseNumber": "10037",
"LicenseNumberStateCode": "FL",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}