{
"Npi": {
"NPI": "1972348092",
"EntityType": "Individual",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": "N",
"IsOrgSubpart": null,
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": null,
"LastName": "COOPER",
"FirstName": "CAMERON",
"MiddleName": "CLAY",
"NamePrefix": null,
"NameSuffix": "I",
"Credential": null,
"OtherOrgName": null,
"OtherOrgNameTypeCode": null,
"OtherLastName": null,
"OtherFirstName": null,
"OtherMiddleName": null,
"OtherNamePrefix": null,
"OtherNameSuffix": null,
"OtherCredential": null,
"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "4058 HEATHER CT",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "NORTHAMPTON",
"MailingAddressStateName": "PA",
"MailingAddressPostalCode": "18067-9572",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "484-735-3774",
"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "1441 SCHOENERSVILLE RD",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "BETHLEHEM",
"PracticeLocationAddressStateName": "PA",
"PracticeLocationAddressPostalCode": "18018-1864",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "484-526-7676",
"PracticeLocationAddressFaxNumber": null,
"EnumerationDate": "06/29/2024",
"LastUpdateDate": "06/29/2024",
"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": "225400000X",
"TaxonomyName": "Rehabilitation Practitioner",
"LicenseNumber": null,
"LicenseNumberStateCode": null,
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}