{
"Npi": {
"NPI": "1285086744",
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"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "CATRINA BOURNE, PLLC",
"LastName": null,
"FirstName": null,
"MiddleName": null,
"NamePrefix": null,
"NameSuffix": null,
"Credential": null,
"OtherOrgName": null,
"OtherOrgNameTypeCode": null,
"OtherLastName": null,
"OtherFirstName": null,
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"OtherNamePrefix": null,
"OtherNameSuffix": null,
"OtherCredential": null,
"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "609 STONEMILL BLVD",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "YUKON",
"MailingAddressStateName": "OK",
"MailingAddressPostalCode": "73099-5770",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "405-919-3332",
"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "1820 COMMONS CIR",
"SecondLinePracticeLocationAddress": "SUITE A",
"PracticeLocationAddressCityName": "YUKON",
"PracticeLocationAddressStateName": "OK",
"PracticeLocationAddressPostalCode": "73099-9518",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "405-265-2778",
"PracticeLocationAddressFaxNumber": "405-494-7274",
"EnumerationDate": "07/08/2016",
"LastUpdateDate": "07/08/2016",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "BOURNE",
"AuthorizedOfficialFirstName": "CATRINA",
"AuthorizedOfficialMiddleName": "FELICE",
"AuthorizedOfficialTitle": "OWNER / PHYSICIAN",
"AuthorizedOfficialNamePrefix": "DR.",
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "M.D.",
"AuthorizedOfficialTelephoneNumber": "405-919-3332",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "207Q00000X",
"TaxonomyName": "Family Medicine Physician",
"LicenseNumber": "23458",
"LicenseNumberStateCode": "OK",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": {
"HealthcareProviderTaxonomyGroup": {
"HealthcareProviderTaxonomyGroupName": "193400000X SINGLE SPECIALTY GROUP",
"HealthcareProviderTaxonomyGroupDescription": "Single Specialty Group - A business group of one or more individual practitioners, all of who practice with the same area of specialization."
}
}
}
}