{
"Npi": {
"NPI": "1447713490",
"EntityType": "Individual",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": "N",
"IsOrgSubpart": null,
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": null,
"LastName": "LE",
"FirstName": "KRISTIN",
"MiddleName": "NICHOLE",
"NamePrefix": "DR.",
"NameSuffix": null,
"Credential": "MD",
"OtherOrgName": null,
"OtherOrgNameTypeCode": null,
"OtherLastName": "LOVVORN",
"OtherFirstName": "KRISTIN",
"OtherMiddleName": "NICHOLE",
"OtherNamePrefix": "DR.",
"OtherNameSuffix": null,
"OtherCredential": null,
"OtherLastNameTypeCode": "1",
"FirstLineMailingAddress": "1600 7TH AVE S FL 4",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "BIRMINGHAM",
"MailingAddressStateName": "AL",
"MailingAddressPostalCode": "35233-1711",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "205-638-9193",
"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "200 WILDWOOD PKWY STE 130",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "HOMEWOOD",
"PracticeLocationAddressStateName": "AL",
"PracticeLocationAddressPostalCode": "35209-7300",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "205-870-5678",
"PracticeLocationAddressFaxNumber": null,
"EnumerationDate": "04/08/2019",
"LastUpdateDate": "09/30/2025",
"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": "2084P0804X",
"TaxonomyName": "Child & Adolescent Psychiatry Physician",
"LicenseNumber": "ME166145",
"LicenseNumberStateCode": "FL",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}