{
"Npi": {
"NPI": "1396085148",
"EntityType": "Individual",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": "Y",
"IsOrgSubpart": null,
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": null,
"LastName": "FARROW",
"FirstName": "LYNN",
"MiddleName": "ANN",
"NamePrefix": null,
"NameSuffix": null,
"Credential": "O.T.",
"OtherOrgName": null,
"OtherOrgNameTypeCode": null,
"OtherLastName": "HOCKING",
"OtherFirstName": "LYNN",
"OtherMiddleName": "ANN",
"OtherNamePrefix": null,
"OtherNameSuffix": null,
"OtherCredential": "O.T.",
"OtherLastNameTypeCode": "1",
"FirstLineMailingAddress": "3535 MOUNTAIN DR",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "BROOKFIELD",
"MailingAddressStateName": "WI",
"MailingAddressPostalCode": "53045-1443",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "262-783-9890",
"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "3073 S CHASE AVE",
"SecondLinePracticeLocationAddress": "SUITE 240",
"PracticeLocationAddressCityName": "MILWAUKEE",
"PracticeLocationAddressStateName": "WI",
"PracticeLocationAddressPostalCode": "53207-2638",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "414-231-4223",
"PracticeLocationAddressFaxNumber": "414-489-0540",
"EnumerationDate": "02/14/2013",
"LastUpdateDate": "02/14/2013",
"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": "302R00000X",
"TaxonomyName": "Health Maintenance Organization",
"LicenseNumber": "1289-26",
"LicenseNumberStateCode": "WI",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}