{
"Npi": {
"NPI": "1124192828",
"EntityType": "Individual",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": "N",
"IsOrgSubpart": null,
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": null,
"LastName": "KING",
"FirstName": "BILLIE",
"MiddleName": null,
"NamePrefix": null,
"NameSuffix": null,
"Credential": "DC",
"OtherOrgName": null,
"OtherOrgNameTypeCode": null,
"OtherLastName": "KING",
"OtherFirstName": "BILLIE",
"OtherMiddleName": null,
"OtherNamePrefix": null,
"OtherNameSuffix": null,
"OtherCredential": "DC",
"OtherLastNameTypeCode": "5",
"FirstLineMailingAddress": "2104 RAYMOND RD",
"SecondLineMailingAddress": "SUITE A",
"MailingAddressCityName": "JACKSON",
"MailingAddressStateName": "MS",
"MailingAddressPostalCode": "39212-2300",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "601-373-1310",
"MailingAddressFaxNumber": "601-373-6804",
"FirstLinePracticeLocationAddress": "6351 I 55 N",
"SecondLinePracticeLocationAddress": "STE 121",
"PracticeLocationAddressCityName": "JACKSON",
"PracticeLocationAddressStateName": "MS",
"PracticeLocationAddressPostalCode": "39213-7861",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "601-373-1310",
"PracticeLocationAddressFaxNumber": "601-373-6804",
"EnumerationDate": "11/17/2006",
"LastUpdateDate": "06/15/2021",
"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": "111N00000X",
"TaxonomyName": "Chiropractor",
"LicenseNumber": "0976",
"LicenseNumberStateCode": "MS",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}