{
"Npi": {
"NPI": "1992564736",
"EntityType": "Individual",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": "Y",
"IsOrgSubpart": null,
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": null,
"LastName": "CAPEL",
"FirstName": "BRIANNA",
"MiddleName": "SHAUNTE",
"NamePrefix": "MS.",
"NameSuffix": null,
"Credential": "RN, CEBP, MAED.",
"OtherOrgName": null,
"OtherOrgNameTypeCode": null,
"OtherLastName": null,
"OtherFirstName": null,
"OtherMiddleName": null,
"OtherNamePrefix": null,
"OtherNameSuffix": null,
"OtherCredential": null,
"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "701 CLEARVIEW DR",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "MADISONVILLE",
"MailingAddressStateName": "KY",
"MailingAddressPostalCode": "42431-3420",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "270-399-5969",
"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "701 CLEARVIEW DR",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "MADISONVILLE",
"PracticeLocationAddressStateName": "KY",
"PracticeLocationAddressPostalCode": "42431-3420",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "270-399-5969",
"PracticeLocationAddressFaxNumber": null,
"EnumerationDate": "03/14/2024",
"LastUpdateDate": "11/15/2024",
"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": "171000000X",
"TaxonomyName": "Military Health Care Provider",
"LicenseNumber": "4008933",
"LicenseNumberStateCode": "KY",
"PrimaryTaxonomySwitch": "N"
},
{
"TaxonomyCode": "251C00000X",
"TaxonomyName": "Developmentally Disabled Services Day Training Agency",
"LicenseNumber": "4008933",
"LicenseNumberStateCode": "KY",
"PrimaryTaxonomySwitch": "N"
},
{
"TaxonomyCode": "251S00000X",
"TaxonomyName": "Community/Behavioral Health Agency",
"LicenseNumber": "4008933",
"LicenseNumberStateCode": "KY",
"PrimaryTaxonomySwitch": "N"
},
{
"TaxonomyCode": "252Y00000X",
"TaxonomyName": "Early Intervention Provider Agency",
"LicenseNumber": null,
"LicenseNumberStateCode": null,
"PrimaryTaxonomySwitch": "N"
},
{
"TaxonomyCode": "364SP0812X",
"TaxonomyName": "Community Psychiatric/Mental Health Clinical Nurse Specialist",
"LicenseNumber": "4008933",
"LicenseNumberStateCode": "KY",
"PrimaryTaxonomySwitch": "N"
},
{
"TaxonomyCode": "373H00000X",
"TaxonomyName": "Day Training/Habilitation Specialist",
"LicenseNumber": "4008933",
"LicenseNumberStateCode": "KY",
"PrimaryTaxonomySwitch": "N"
},
{
"TaxonomyCode": "385HR2055X",
"TaxonomyName": "Child Mental Illness Respite Care",
"LicenseNumber": "4008933",
"LicenseNumberStateCode": "KY",
"PrimaryTaxonomySwitch": "N"
},
{
"TaxonomyCode": "163W00000X",
"TaxonomyName": "Registered Nurse",
"LicenseNumber": "4008933",
"LicenseNumberStateCode": "KY",
"PrimaryTaxonomySwitch": "Y"
},
{
"TaxonomyCode": "385HR2060X",
"TaxonomyName": "Child Intellectual and/or Developmental Disabilities Respite Care",
"LicenseNumber": "4008933",
"LicenseNumberStateCode": "KY",
"PrimaryTaxonomySwitch": "N"
},
{
"TaxonomyCode": "163WC1500X",
"TaxonomyName": "Community Health Registered Nurse",
"LicenseNumber": "4008933",
"LicenseNumberStateCode": "KY",
"PrimaryTaxonomySwitch": "N"
},
{
"TaxonomyCode": "163WP0807X",
"TaxonomyName": "Child & Adolescent Psychiatric/Mental Health Registered Nurse",
"LicenseNumber": "4008933",
"LicenseNumberStateCode": "KY",
"PrimaryTaxonomySwitch": "N"
}
]
},
"HealthcareProviderTaxonomyGroups": {
"HealthcareProviderTaxonomyGroup": {
"HealthcareProviderTaxonomyGroupName": "193200000X MULTI-SPECIALTY GROUP",
"HealthcareProviderTaxonomyGroupDescription": "Multi-Specialty Group - A business group of one or more individual practitioners, who practice with different areas of specialization."
}
}
}
}