{
"Npi": {
"NPI": "1568852572",
"EntityType": "Individual",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": "N",
"IsOrgSubpart": null,
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": null,
"LastName": "BASS-GRAY",
"FirstName": "BRITTNEY",
"MiddleName": null,
"NamePrefix": "MRS.",
"NameSuffix": null,
"Credential": "HAIR LOSS SPECIALIST",
"OtherOrgName": null,
"OtherOrgNameTypeCode": null,
"OtherLastName": null,
"OtherFirstName": null,
"OtherMiddleName": null,
"OtherNamePrefix": null,
"OtherNameSuffix": null,
"OtherCredential": null,
"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "1251 BEACON PKWY E",
"SecondLineMailingAddress": "UNIT 202",
"MailingAddressCityName": "BIRMINGHAM",
"MailingAddressStateName": "AL",
"MailingAddressPostalCode": "35209-1069",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "205-478-7518",
"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "1251 BEACON PKWY E",
"SecondLinePracticeLocationAddress": "UNIT 202",
"PracticeLocationAddressCityName": "BIRMINGHAM",
"PracticeLocationAddressStateName": "AL",
"PracticeLocationAddressPostalCode": "35209-1069",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "205-478-7518",
"PracticeLocationAddressFaxNumber": null,
"EnumerationDate": "01/28/2015",
"LastUpdateDate": "11/19/2015",
"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": "174400000X",
"TaxonomyName": "Specialist",
"LicenseNumber": "464164219",
"LicenseNumberStateCode": "AL",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}