{
"Npi": {
"NPI": "1588608699",
"EntityType": "Individual",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": "N",
"IsOrgSubpart": null,
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": null,
"LastName": "ANDERSON",
"FirstName": "LAURIE",
"MiddleName": "HARLAN",
"NamePrefix": "DR.",
"NameSuffix": null,
"Credential": "MD",
"OtherOrgName": null,
"OtherOrgNameTypeCode": null,
"OtherLastName": null,
"OtherFirstName": null,
"OtherMiddleName": null,
"OtherNamePrefix": null,
"OtherNameSuffix": null,
"OtherCredential": null,
"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "PO BOX 497",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "AUGUSTA",
"MailingAddressStateName": "AR",
"MailingAddressPostalCode": "72006-0497",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "870-347-2534",
"MailingAddressFaxNumber": "870-347-3492",
"FirstLinePracticeLocationAddress": "601 W MAPLE AVE",
"SecondLinePracticeLocationAddress": "SUITE 401",
"PracticeLocationAddressCityName": "SPRINGDALE",
"PracticeLocationAddressStateName": "AR",
"PracticeLocationAddressPostalCode": "72764-5335",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "479-751-2989",
"PracticeLocationAddressFaxNumber": "479-757-2989",
"EnumerationDate": "06/16/2006",
"LastUpdateDate": "02/18/2020",
"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": "208000000X",
"TaxonomyName": "Pediatrics Physician",
"LicenseNumber": "C8262",
"LicenseNumberStateCode": "AR",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}