{
"Npi": {
"NPI": "1093026437",
"EntityType": "Individual",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": "Y",
"IsOrgSubpart": null,
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": null,
"LastName": "OSBORN",
"FirstName": "AUSTIN",
"MiddleName": "BALLARD",
"NamePrefix": "DR.",
"NameSuffix": null,
"Credential": "M.D.",
"OtherOrgName": null,
"OtherOrgNameTypeCode": null,
"OtherLastName": null,
"OtherFirstName": null,
"OtherMiddleName": null,
"OtherNamePrefix": null,
"OtherNameSuffix": null,
"OtherCredential": null,
"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "875 W POPLAR AVE STE 23-377",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "COLLIERVILLE",
"MailingAddressStateName": "TN",
"MailingAddressPostalCode": "38017-2513",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "901-501-7039",
"MailingAddressFaxNumber": "877-578-2807",
"FirstLinePracticeLocationAddress": "875 W POPLAR AVE STE 23-377",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "COLLIERVILLE",
"PracticeLocationAddressStateName": "TN",
"PracticeLocationAddressPostalCode": "38017-2513",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "901-501-7039",
"PracticeLocationAddressFaxNumber": "877-578-2807",
"EnumerationDate": "06/30/2010",
"LastUpdateDate": "02/10/2022",
"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": "2084P0800X",
"TaxonomyName": "Psychiatry Physician",
"LicenseNumber": "51032",
"LicenseNumberStateCode": "TN",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}