{
"Npi": {
"NPI": "1013366905",
"EntityType": "Individual",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": "N",
"IsOrgSubpart": null,
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": null,
"LastName": "ABBOTT",
"FirstName": "BRIANNA",
"MiddleName": "J",
"NamePrefix": "MRS.",
"NameSuffix": null,
"Credential": "PA-C",
"OtherOrgName": null,
"OtherOrgNameTypeCode": null,
"OtherLastName": null,
"OtherFirstName": null,
"OtherMiddleName": null,
"OtherNamePrefix": null,
"OtherNameSuffix": null,
"OtherCredential": null,
"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "2695 ROCKY MOUNTAIN AVE STE 150",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "LOVELAND",
"MailingAddressStateName": "CO",
"MailingAddressPostalCode": "80538-9071",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "970-624-4034",
"MailingAddressFaxNumber": "970-490-4173",
"FirstLinePracticeLocationAddress": "4110 BRIARGATE PKWY STE 445",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "COLORADO SPRINGS",
"PracticeLocationAddressStateName": "CO",
"PracticeLocationAddressPostalCode": "80920-7839",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "719-364-8840",
"PracticeLocationAddressFaxNumber": "719-364-3597",
"EnumerationDate": "06/10/2016",
"LastUpdateDate": "07/24/2025",
"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": "363AM0700X",
"TaxonomyName": "Medical Physician Assistant",
"LicenseNumber": "TC483",
"LicenseNumberStateCode": "KY",
"PrimaryTaxonomySwitch": "N"
},
{
"TaxonomyCode": "363A00000X",
"TaxonomyName": "Physician Assistant",
"LicenseNumber": "PA.0006902",
"LicenseNumberStateCode": "CO",
"PrimaryTaxonomySwitch": "Y"
},
{
"TaxonomyCode": "363A00000X",
"TaxonomyName": "Physician Assistant",
"LicenseNumber": "10002591A",
"LicenseNumberStateCode": "IN",
"PrimaryTaxonomySwitch": "N"
}
]
},
"HealthcareProviderTaxonomyGroups": null
}
}