{
"Npi": {
"NPI": "1225860711",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "GREEN LOTUS HEALTH & WELLNESS, PLLC",
"LastName": null,
"FirstName": null,
"MiddleName": null,
"NamePrefix": null,
"NameSuffix": null,
"Credential": null,
"OtherOrgName": null,
"OtherOrgNameTypeCode": null,
"OtherLastName": null,
"OtherFirstName": null,
"OtherMiddleName": null,
"OtherNamePrefix": null,
"OtherNameSuffix": null,
"OtherCredential": null,
"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "212 NW 5TH STREET",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "GUYMON",
"MailingAddressStateName": "OK",
"MailingAddressPostalCode": "73942-4204",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "580-338-7462",
"MailingAddressFaxNumber": "855-538-3350",
"FirstLinePracticeLocationAddress": "2101 S BLACKHAWK ST STE 240",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "AURORA",
"PracticeLocationAddressStateName": "CO",
"PracticeLocationAddressPostalCode": "80014-1475",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "501-613-7863",
"PracticeLocationAddressFaxNumber": "580-297-9105",
"EnumerationDate": "08/14/2024",
"LastUpdateDate": "12/20/2025",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "BROWN",
"AuthorizedOfficialFirstName": "MARLENE",
"AuthorizedOfficialMiddleName": "ANGELA",
"AuthorizedOfficialTitle": "OWNER",
"AuthorizedOfficialNamePrefix": null,
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "APRN-CNP, PMHNP-BC",
"AuthorizedOfficialTelephoneNumber": "580-338-7462",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "363LP0808X",
"TaxonomyName": "Psychiatric/Mental Health Nurse Practitioner",
"LicenseNumber": null,
"LicenseNumberStateCode": null,
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": {
"HealthcareProviderTaxonomyGroup": {
"HealthcareProviderTaxonomyGroupName": "193200000X MULTI-SPECIALTY GROUP",
"HealthcareProviderTaxonomyGroupDescription": "Multi-Specialty Group - A business group of one or more individual practitioners, who practice with different areas of specialization."
}
}
}
}