{
"Npi": {
"NPI": "1124677869",
"EntityType": "Individual",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": "N",
"IsOrgSubpart": null,
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": null,
"LastName": "COX",
"FirstName": "KELLIE",
"MiddleName": "LORRAINE",
"NamePrefix": null,
"NameSuffix": null,
"Credential": "RNFA",
"OtherOrgName": null,
"OtherOrgNameTypeCode": null,
"OtherLastName": null,
"OtherFirstName": null,
"OtherMiddleName": null,
"OtherNamePrefix": null,
"OtherNameSuffix": null,
"OtherCredential": null,
"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "PO BOX 50924",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "PHOENIX",
"MailingAddressStateName": "AZ",
"MailingAddressPostalCode": "85076-0924",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "480-332-7336",
"MailingAddressFaxNumber": "480-545-2610",
"FirstLinePracticeLocationAddress": "9201 W THOMAS RD",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "PHOENIX",
"PracticeLocationAddressStateName": "AZ",
"PracticeLocationAddressPostalCode": "85037-3332",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "623-327-4000",
"PracticeLocationAddressFaxNumber": null,
"EnumerationDate": "09/05/2019",
"LastUpdateDate": "09/05/2019",
"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": "163WR0006X",
"TaxonomyName": "Registered Nurse First Assistant",
"LicenseNumber": "1721491",
"LicenseNumberStateCode": "AZ",
"PrimaryTaxonomySwitch": "N"
},
{
"TaxonomyCode": "163WR0006X",
"TaxonomyName": "Registered Nurse First Assistant",
"LicenseNumber": "RN209418",
"LicenseNumberStateCode": "AZ",
"PrimaryTaxonomySwitch": "Y"
}
]
},
"HealthcareProviderTaxonomyGroups": null
}
}