{
"Npi": {
"NPI": "1578635264",
"EntityType": "Individual",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": "N",
"IsOrgSubpart": null,
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": null,
"LastName": "RANDLE",
"FirstName": "JULIA",
"MiddleName": null,
"NamePrefix": "MS.",
"NameSuffix": null,
"Credential": "OT",
"OtherOrgName": null,
"OtherOrgNameTypeCode": null,
"OtherLastName": "MERITT",
"OtherFirstName": "JULIA",
"OtherMiddleName": null,
"OtherNamePrefix": null,
"OtherNameSuffix": null,
"OtherCredential": "OT",
"OtherLastNameTypeCode": "1",
"FirstLineMailingAddress": "PO BOX 757",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "MESQUITE",
"MailingAddressStateName": "NV",
"MailingAddressPostalCode": "89024",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "702-346-1899",
"MailingAddressFaxNumber": "702-346-8581",
"FirstLinePracticeLocationAddress": "1140 W PIONEER BLVD",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "MESQUITE",
"PracticeLocationAddressStateName": "NV",
"PracticeLocationAddressPostalCode": "89027",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "702-346-1899",
"PracticeLocationAddressFaxNumber": "702-346-8581",
"EnumerationDate": "11/15/2006",
"LastUpdateDate": "11/15/2024",
"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": "225X00000X",
"TaxonomyName": "Occupational Therapist",
"LicenseNumber": "6107697-4201",
"LicenseNumberStateCode": "UT",
"PrimaryTaxonomySwitch": "N"
},
{
"TaxonomyCode": "225XP0019X",
"TaxonomyName": "Physical Rehabilitation Occupational Therapist",
"LicenseNumber": "OT-2721",
"LicenseNumberStateCode": "NV",
"PrimaryTaxonomySwitch": "Y"
}
]
},
"HealthcareProviderTaxonomyGroups": null
}
}