{
"Npi": {
"NPI": "1265781686",
"EntityType": "Individual",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": "Y",
"IsOrgSubpart": null,
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": null,
"LastName": "POPP",
"FirstName": "COURTNEY",
"MiddleName": "ROSE",
"NamePrefix": "DR.",
"NameSuffix": null,
"Credential": "PHARM.D.",
"OtherOrgName": null,
"OtherOrgNameTypeCode": null,
"OtherLastName": "MCNETT",
"OtherFirstName": "COURTNEY",
"OtherMiddleName": "ROSE",
"OtherNamePrefix": "DR.",
"OtherNameSuffix": null,
"OtherCredential": "PHARM.D.",
"OtherLastNameTypeCode": "1",
"FirstLineMailingAddress": "1109 E MOREHEAD ST APT 13",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "CHARLOTTE",
"MailingAddressStateName": "NC",
"MailingAddressPostalCode": "28204-2852",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "248-255-8151",
"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "8830 ALBEMARLE RD",
"SecondLinePracticeLocationAddress": "T1793",
"PracticeLocationAddressCityName": "CHARLOTTE",
"PracticeLocationAddressStateName": "NC",
"PracticeLocationAddressPostalCode": "28227-2616",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "704-264-0079",
"PracticeLocationAddressFaxNumber": null,
"EnumerationDate": "08/30/2012",
"LastUpdateDate": "09/10/2014",
"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": "5302038931",
"LicenseNumberStateCode": "MI",
"PrimaryTaxonomySwitch": "N"
},
{
"TaxonomyCode": "183500000X",
"TaxonomyName": "Pharmacist",
"LicenseNumber": "23972",
"LicenseNumberStateCode": "NC",
"PrimaryTaxonomySwitch": "Y"
}
]
},
"HealthcareProviderTaxonomyGroups": null
}
}