{
"Npi": {
"NPI": "1992669725",
"EntityType": "Individual",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": "N",
"IsOrgSubpart": null,
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": null,
"LastName": "RANGEL",
"FirstName": "JESSICA",
"MiddleName": null,
"NamePrefix": null,
"NameSuffix": null,
"Credential": "PA",
"OtherOrgName": null,
"OtherOrgNameTypeCode": null,
"OtherLastName": null,
"OtherFirstName": null,
"OtherMiddleName": null,
"OtherNamePrefix": null,
"OtherNameSuffix": null,
"OtherCredential": null,
"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "3656 HIGHWAY 52A",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "CHATSWORTH",
"MailingAddressStateName": "GA",
"MailingAddressPostalCode": "30705-7706",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "706-934-5560",
"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "707 OLD DALTON ELLIJAY RD",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "CHATSWORTH",
"PracticeLocationAddressStateName": "GA",
"PracticeLocationAddressPostalCode": "30705-2029",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "706-695-4564",
"PracticeLocationAddressFaxNumber": null,
"EnumerationDate": "12/15/2025",
"LastUpdateDate": "12/15/2025",
"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": "363A00000X",
"TaxonomyName": "Physician Assistant",
"LicenseNumber": null,
"LicenseNumberStateCode": null,
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}