{
"Npi": {
"NPI": "1730566274",
"EntityType": "Individual",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": "N",
"IsOrgSubpart": null,
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": null,
"LastName": "MONTGOMERY",
"FirstName": "MELODY",
"MiddleName": "MARIE",
"NamePrefix": "DR.",
"NameSuffix": null,
"Credential": "PHARMD",
"OtherOrgName": null,
"OtherOrgNameTypeCode": null,
"OtherLastName": "SANCHEZ",
"OtherFirstName": "MELODY",
"OtherMiddleName": "MARIE",
"OtherNamePrefix": "DR.",
"OtherNameSuffix": null,
"OtherCredential": "PHARMD",
"OtherLastNameTypeCode": "1",
"FirstLineMailingAddress": "35629 HIGHWAY 72",
"SecondLineMailingAddress": "PO BOX 774",
"MailingAddressCityName": "SALEM",
"MailingAddressStateName": "MO",
"MailingAddressPostalCode": "65560-7217",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "573-729-5917",
"MailingAddressFaxNumber": "573-729-8002",
"FirstLinePracticeLocationAddress": "35629 HIGHWAY 72",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "SALEM",
"PracticeLocationAddressStateName": "MO",
"PracticeLocationAddressPostalCode": "65560-7217",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "573-729-5917",
"PracticeLocationAddressFaxNumber": "573-729-8002",
"EnumerationDate": "05/05/2015",
"LastUpdateDate": "05/05/2015",
"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": "183500000X",
"TaxonomyName": "Pharmacist",
"LicenseNumber": "2008004322",
"LicenseNumberStateCode": "MO",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}