{
"Npi": {
"NPI": "1295321495",
"EntityType": "Individual",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": "Y",
"IsOrgSubpart": null,
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": null,
"LastName": "DUNCAN",
"FirstName": "JENNIFER",
"MiddleName": "LONGMIRE",
"NamePrefix": null,
"NameSuffix": null,
"Credential": "PHARMD, BCGP",
"OtherOrgName": null,
"OtherOrgNameTypeCode": null,
"OtherLastName": "WILSON",
"OtherFirstName": "JENNIFER",
"OtherMiddleName": "LONGMIRE",
"OtherNamePrefix": null,
"OtherNameSuffix": null,
"OtherCredential": "PHARMD",
"OtherLastNameTypeCode": "1",
"FirstLineMailingAddress": "611 MERGANSER TRL",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "CLINTON",
"MailingAddressStateName": "MS",
"MailingAddressPostalCode": "39056-6259",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "601-850-6353",
"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "100 BUSINESS PARK DR STE D",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "RIDGELAND",
"PracticeLocationAddressStateName": "MS",
"PracticeLocationAddressPostalCode": "39157-6015",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "601-214-9665",
"PracticeLocationAddressFaxNumber": "800-547-9182",
"EnumerationDate": "12/12/2020",
"LastUpdateDate": "12/12/2020",
"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": "1835G0303X",
"TaxonomyName": "Geriatric Pharmacist",
"LicenseNumber": "T-07963",
"LicenseNumberStateCode": "MS",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}