{
"Npi": {
"NPI": "1245057454",
"EntityType": "Individual",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": "N",
"IsOrgSubpart": null,
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": null,
"LastName": "BECKETT",
"FirstName": "EMILY",
"MiddleName": null,
"NamePrefix": null,
"NameSuffix": null,
"Credential": "PMHNP-BC",
"OtherOrgName": null,
"OtherOrgNameTypeCode": null,
"OtherLastName": "HALL",
"OtherFirstName": "EMILY",
"OtherMiddleName": "ANNE",
"OtherNamePrefix": null,
"OtherNameSuffix": null,
"OtherCredential": null,
"OtherLastNameTypeCode": "1",
"FirstLineMailingAddress": "PO BOX 20092",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "CHEYENNE",
"MailingAddressStateName": "WY",
"MailingAddressPostalCode": "82003-7002",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "307-630-4729",
"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "1301 RIVERSIDE AVE",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "FORT COLLINS",
"PracticeLocationAddressStateName": "CO",
"PracticeLocationAddressPostalCode": "80524-4374",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "970-888-4070",
"PracticeLocationAddressFaxNumber": null,
"EnumerationDate": "09/20/2024",
"LastUpdateDate": "03/03/2025",
"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": "363L00000X",
"TaxonomyName": "Nurse Practitioner",
"LicenseNumber": "55687",
"LicenseNumberStateCode": "WY",
"PrimaryTaxonomySwitch": "N"
},
{
"TaxonomyCode": "363LP0808X",
"TaxonomyName": "Psychiatric/Mental Health Nurse Practitioner",
"LicenseNumber": "1000087",
"LicenseNumberStateCode": "CO",
"PrimaryTaxonomySwitch": "N"
},
{
"TaxonomyCode": "363LP0808X",
"TaxonomyName": "Psychiatric/Mental Health Nurse Practitioner",
"LicenseNumber": "55687",
"LicenseNumberStateCode": "WY",
"PrimaryTaxonomySwitch": "N"
},
{
"TaxonomyCode": "363L00000X",
"TaxonomyName": "Nurse Practitioner",
"LicenseNumber": "1000087",
"LicenseNumberStateCode": "CO",
"PrimaryTaxonomySwitch": "Y"
}
]
},
"HealthcareProviderTaxonomyGroups": null
}
}