{
"Npi": {
"NPI": "1306468327",
"EntityType": "Individual",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": "N",
"IsOrgSubpart": null,
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": null,
"LastName": "PAYNE",
"FirstName": "LARA",
"MiddleName": null,
"NamePrefix": null,
"NameSuffix": null,
"Credential": "PHARMD",
"OtherOrgName": null,
"OtherOrgNameTypeCode": null,
"OtherLastName": null,
"OtherFirstName": null,
"OtherMiddleName": null,
"OtherNamePrefix": null,
"OtherNameSuffix": null,
"OtherCredential": null,
"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "3583 CREEK XING",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "AMELIA",
"MailingAddressStateName": "OH",
"MailingAddressPostalCode": "45102-1764",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "513-720-9078",
"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "4361 IRWIN SIMPSON RD",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "MASON",
"PracticeLocationAddressStateName": "OH",
"PracticeLocationAddressPostalCode": "45040-9479",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "513-204-3200",
"PracticeLocationAddressFaxNumber": null,
"EnumerationDate": "05/13/2020",
"LastUpdateDate": "05/13/2020",
"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": "1835P0018X",
"TaxonomyName": "Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist",
"LicenseNumber": "031275611",
"LicenseNumberStateCode": "OH",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}