{
"Npi": {
"NPI": "1104943489",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "VERN H HORTON MD PC",
"LastName": null,
"FirstName": null,
"MiddleName": null,
"NamePrefix": null,
"NameSuffix": null,
"Credential": null,
"OtherOrgName": null,
"OtherOrgNameTypeCode": null,
"OtherLastName": null,
"OtherFirstName": null,
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"OtherNamePrefix": null,
"OtherNameSuffix": null,
"OtherCredential": null,
"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "5750 COCHISE DRIVE",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "MISSOULA",
"MailingAddressStateName": "MT",
"MailingAddressPostalCode": "59804-9746",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "406-251-2160",
"MailingAddressFaxNumber": "406-251-2160",
"FirstLinePracticeLocationAddress": "2827 FT MISSOULA RD",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "MISSOULA",
"PracticeLocationAddressStateName": "MT",
"PracticeLocationAddressPostalCode": "59804",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "406-728-4100",
"PracticeLocationAddressFaxNumber": "406-327-4502",
"EnumerationDate": "03/23/2007",
"LastUpdateDate": "01/07/2008",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "HORTON",
"AuthorizedOfficialFirstName": "SUZANNE",
"AuthorizedOfficialMiddleName": "BALL",
"AuthorizedOfficialTitle": "OFFICE MANAGER CORP SECRETARY",
"AuthorizedOfficialNamePrefix": "MRS.",
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": null,
"AuthorizedOfficialTelephoneNumber": "406-251-2160",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "208600000X",
"TaxonomyName": "Surgery Physician",
"LicenseNumber": "3719",
"LicenseNumberStateCode": "MT",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": {
"HealthcareProviderTaxonomyGroup": {
"HealthcareProviderTaxonomyGroupName": "193400000X SINGLE SPECIALTY GROUP",
"HealthcareProviderTaxonomyGroupDescription": "Single Specialty Group - A business group of one or more individual practitioners, all of who practice with the same area of specialization."
}
}
}
}