{
"Npi": {
"NPI": "1780066035",
"EntityType": "Individual",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": "N",
"IsOrgSubpart": null,
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": null,
"LastName": "IVY",
"FirstName": "KARLA",
"MiddleName": "RENISE",
"NamePrefix": "DR.",
"NameSuffix": null,
"Credential": "D.O.",
"OtherOrgName": null,
"OtherOrgNameTypeCode": null,
"OtherLastName": "RINSCHEN",
"OtherFirstName": "KARLA",
"OtherMiddleName": "RENISE",
"OtherNamePrefix": null,
"OtherNameSuffix": null,
"OtherCredential": null,
"OtherLastNameTypeCode": "1",
"FirstLineMailingAddress": "221 3RD ST W BLDG 1040",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "JBSA RANDOLPH",
"MailingAddressStateName": "TX",
"MailingAddressPostalCode": "78150-4800",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "210-652-5363",
"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "221 3RD ST W BLDG 1040",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "JBSA RANDOLPH",
"PracticeLocationAddressStateName": "TX",
"PracticeLocationAddressPostalCode": "78150-4800",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "210-652-5363",
"PracticeLocationAddressFaxNumber": null,
"EnumerationDate": "06/23/2015",
"LastUpdateDate": "06/24/2022",
"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": "207Q00000X",
"TaxonomyName": "Family Medicine Physician",
"LicenseNumber": "1745",
"LicenseNumberStateCode": "NE",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}