{
"Npi": {
"NPI": "1487170056",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "KATHRYN BRAKEMEIER",
"LastName": null,
"FirstName": null,
"MiddleName": null,
"NamePrefix": null,
"NameSuffix": null,
"Credential": null,
"OtherOrgName": null,
"OtherOrgNameTypeCode": "6",
"OtherLastName": null,
"OtherFirstName": null,
"OtherMiddleName": null,
"OtherNamePrefix": null,
"OtherNameSuffix": null,
"OtherCredential": null,
"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "3628 HORACE AVE",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "FORT WORTH",
"MailingAddressStateName": "TX",
"MailingAddressPostalCode": "76244-8664",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": null,
"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "3628 HORACE AVE",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "FORT WORTH",
"PracticeLocationAddressStateName": "TX",
"PracticeLocationAddressPostalCode": "76244-8664",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "817-706-9566",
"PracticeLocationAddressFaxNumber": null,
"EnumerationDate": "08/16/2017",
"LastUpdateDate": "08/16/2017",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "BRAKEMEIER",
"AuthorizedOfficialFirstName": "KATHRYN",
"AuthorizedOfficialMiddleName": null,
"AuthorizedOfficialTitle": "SPEECH-LANGUAGE PATHOLOGIST",
"AuthorizedOfficialNamePrefix": null,
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": null,
"AuthorizedOfficialTelephoneNumber": "817-706-9566",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "261QH0700X",
"TaxonomyName": "Hearing and Speech Clinic/Center",
"LicenseNumber": "100296",
"LicenseNumberStateCode": "TX",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}