{
"Npi": {
"NPI": "1245580893",
"EntityType": "Individual",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": "N",
"IsOrgSubpart": null,
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": null,
"LastName": "JUSTICE",
"FirstName": "CAROL",
"MiddleName": "WHITE",
"NamePrefix": "DR.",
"NameSuffix": null,
"Credential": "PHARMD",
"OtherOrgName": null,
"OtherOrgNameTypeCode": null,
"OtherLastName": "WHITE",
"OtherFirstName": "CAROL",
"OtherMiddleName": "LYNETTE",
"OtherNamePrefix": "DR.",
"OtherNameSuffix": null,
"OtherCredential": "PHARMD",
"OtherLastNameTypeCode": "1",
"FirstLineMailingAddress": "2629 CALUMET DR SE",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "BROWNSBORO",
"MailingAddressStateName": "AL",
"MailingAddressPostalCode": "35741-9379",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "615-946-7286",
"MailingAddressFaxNumber": "615-591-1102",
"FirstLinePracticeLocationAddress": "2629 CALUMET DR SE",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "BROWNSBORO",
"PracticeLocationAddressStateName": "AL",
"PracticeLocationAddressPostalCode": "35741-9379",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "615-946-7286",
"PracticeLocationAddressFaxNumber": null,
"EnumerationDate": "09/11/2012",
"LastUpdateDate": "01/02/2025",
"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": "183500000X",
"TaxonomyName": "Pharmacist",
"LicenseNumber": "33608",
"LicenseNumberStateCode": "TN",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}