{
"Npi": {
"NPI": "1194502021",
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"EIN": null,
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"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "WALKING TREE FAMILY PRACTICE, INC",
"LastName": null,
"FirstName": null,
"MiddleName": null,
"NamePrefix": null,
"NameSuffix": null,
"Credential": null,
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"OtherCredential": null,
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"FirstLineMailingAddress": "3098 W LAKE MARY BLVD",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "LAKE MARY",
"MailingAddressStateName": "FL",
"MailingAddressPostalCode": "32746-6742",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": null,
"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "3098 W LAKE MARY BLVD",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "LAKE MARY",
"PracticeLocationAddressStateName": "FL",
"PracticeLocationAddressPostalCode": "32746-6742",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "406-855-9722",
"PracticeLocationAddressFaxNumber": null,
"EnumerationDate": "09/13/2023",
"LastUpdateDate": "09/13/2023",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "FAIRBAIRN",
"AuthorizedOfficialFirstName": "BESSIE",
"AuthorizedOfficialMiddleName": "JOYCE",
"AuthorizedOfficialTitle": "DR. FAIRBAIRN/OWNER",
"AuthorizedOfficialNamePrefix": "DR.",
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "DNP, APRN, FNP-BC",
"AuthorizedOfficialTelephoneNumber": "406-855-9722",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "261QP2300X",
"TaxonomyName": "Primary Care Clinic/Center",
"LicenseNumber": null,
"LicenseNumberStateCode": null,
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}