{
"Npi": {
"NPI": "1003781808",
"EntityType": "Individual",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": "Y",
"IsOrgSubpart": null,
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": null,
"LastName": "FARMER",
"FirstName": "JESSE",
"MiddleName": "MICHAEL",
"NamePrefix": null,
"NameSuffix": "SR.",
"Credential": "RN",
"OtherOrgName": null,
"OtherOrgNameTypeCode": null,
"OtherLastName": null,
"OtherFirstName": null,
"OtherMiddleName": null,
"OtherNamePrefix": null,
"OtherNameSuffix": null,
"OtherCredential": null,
"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "1252 N 4080 RD",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "BOSWELL",
"MailingAddressStateName": "OK",
"MailingAddressPostalCode": "74727-9265",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "660-654-4009",
"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "1252 N 4080 RD",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "BOSWELL",
"PracticeLocationAddressStateName": "OK",
"PracticeLocationAddressPostalCode": "74727-9265",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "660-654-4009",
"PracticeLocationAddressFaxNumber": null,
"EnumerationDate": "10/09/2025",
"LastUpdateDate": "10/09/2025",
"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": "163WG0000X",
"TaxonomyName": "General Practice Registered Nurse",
"LicenseNumber": "2014022224",
"LicenseNumberStateCode": "MO",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}