{
"Npi": {
"NPI": "1760449029",
"EntityType": "Individual",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": "N",
"IsOrgSubpart": null,
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": null,
"LastName": "SCHAFER",
"FirstName": "CHRISTINA",
"MiddleName": "JO",
"NamePrefix": null,
"NameSuffix": null,
"Credential": "PA-C",
"OtherOrgName": null,
"OtherOrgNameTypeCode": null,
"OtherLastName": "VIDACAK",
"OtherFirstName": "CHRISTINA",
"OtherMiddleName": "JO",
"OtherNamePrefix": null,
"OtherNameSuffix": null,
"OtherCredential": "P.A.",
"OtherLastNameTypeCode": "1",
"FirstLineMailingAddress": "8131 S MEMORIAL DR STE 100",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "TULSA",
"MailingAddressStateName": "OK",
"MailingAddressPostalCode": "74133-4348",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "918-200-9944",
"MailingAddressFaxNumber": "877-616-3089",
"FirstLinePracticeLocationAddress": "8131 S MEMORIAL DR STE 100",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "TULSA",
"PracticeLocationAddressStateName": "OK",
"PracticeLocationAddressPostalCode": "74133-4348",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "918-200-9944",
"PracticeLocationAddressFaxNumber": "877-616-3089",
"EnumerationDate": "04/28/2006",
"LastUpdateDate": "09/17/2025",
"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": "363AM0700X",
"TaxonomyName": "Medical Physician Assistant",
"LicenseNumber": "1183",
"LicenseNumberStateCode": "OK",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}