{
"Npi": {
"NPI": "1114453073",
"EntityType": "Individual",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": "N",
"IsOrgSubpart": null,
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": null,
"LastName": "JORDAN",
"FirstName": "KELSEY",
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"NamePrefix": null,
"NameSuffix": null,
"Credential": "M.A.",
"OtherOrgName": null,
"OtherOrgNameTypeCode": null,
"OtherLastName": null,
"OtherFirstName": null,
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"OtherNamePrefix": null,
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"OtherCredential": null,
"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "3005 19TH ST",
"SecondLineMailingAddress": "SUITE 700",
"MailingAddressCityName": "COLUMBUS",
"MailingAddressStateName": "NE",
"MailingAddressPostalCode": "68601-4248",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "402-606-3084",
"MailingAddressFaxNumber": "402-606-4693",
"FirstLinePracticeLocationAddress": "3005 19TH ST",
"SecondLinePracticeLocationAddress": "SUITE 700",
"PracticeLocationAddressCityName": "COLUMBUS",
"PracticeLocationAddressStateName": "NE",
"PracticeLocationAddressPostalCode": "68601-4248",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "402-606-3084",
"PracticeLocationAddressFaxNumber": "402-606-4693",
"EnumerationDate": "05/11/2017",
"LastUpdateDate": "05/11/2017",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": "F",
"Gender": "Female",
"AuthorizedOfficialLastName": null,
"AuthorizedOfficialFirstName": null,
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"AuthorizedOfficialTitle": null,
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"AuthorizedOfficialCredential": null,
"AuthorizedOfficialTelephoneNumber": null,
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "106H00000X",
"TaxonomyName": "Marriage & Family Therapist",
"LicenseNumber": "11142",
"LicenseNumberStateCode": "NE",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}