{
"Npi": {
"NPI": "1982631057",
"EntityType": "Individual",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": "N",
"IsOrgSubpart": null,
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": null,
"LastName": "GILMER",
"FirstName": "MICHELLE",
"MiddleName": "K",
"NamePrefix": "MRS.",
"NameSuffix": null,
"Credential": "O.T.R., DPT, MSHA",
"OtherOrgName": null,
"OtherOrgNameTypeCode": null,
"OtherLastName": "KING-GILMER",
"OtherFirstName": "MICHELLE",
"OtherMiddleName": "K",
"OtherNamePrefix": null,
"OtherNameSuffix": null,
"OtherCredential": "PT OT",
"OtherLastNameTypeCode": "2",
"FirstLineMailingAddress": "1949 SUGARLAND DRIVE",
"SecondLineMailingAddress": "SUITE 200",
"MailingAddressCityName": "SHERIDAN",
"MailingAddressStateName": "WY",
"MailingAddressPostalCode": "82801-5755",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "307-461-9891",
"MailingAddressFaxNumber": "307-939-7097",
"FirstLinePracticeLocationAddress": "1949 SUGARLAND DRIVE",
"SecondLinePracticeLocationAddress": "SUITE 200",
"PracticeLocationAddressCityName": "SHERIDAN",
"PracticeLocationAddressStateName": "WY",
"PracticeLocationAddressPostalCode": "82801-5755",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "307-461-9891",
"PracticeLocationAddressFaxNumber": "307-939-7097",
"EnumerationDate": "06/26/2006",
"LastUpdateDate": "06/05/2020",
"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": "225100000X",
"TaxonomyName": "Physical Therapist",
"LicenseNumber": "10223",
"LicenseNumberStateCode": "CO",
"PrimaryTaxonomySwitch": "N"
},
{
"TaxonomyCode": "225X00000X",
"TaxonomyName": "Occupational Therapist",
"LicenseNumber": "2269",
"LicenseNumberStateCode": "CO",
"PrimaryTaxonomySwitch": "N"
},
{
"TaxonomyCode": "225X00000X",
"TaxonomyName": "Occupational Therapist",
"LicenseNumber": "886",
"LicenseNumberStateCode": "WY",
"PrimaryTaxonomySwitch": "N"
},
{
"TaxonomyCode": "225100000X",
"TaxonomyName": "Physical Therapist",
"LicenseNumber": "1358",
"LicenseNumberStateCode": "WY",
"PrimaryTaxonomySwitch": "Y"
}
]
},
"HealthcareProviderTaxonomyGroups": null
}
}