{
"Npi": {
"NPI": "1790168003",
"EntityType": "Individual",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": "N",
"IsOrgSubpart": null,
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": null,
"LastName": "MOY",
"FirstName": "VICTORIA-LEE",
"MiddleName": "NGAR-YAN",
"NamePrefix": null,
"NameSuffix": null,
"Credential": "DC, PHARMD",
"OtherOrgName": null,
"OtherOrgNameTypeCode": null,
"OtherLastName": null,
"OtherFirstName": null,
"OtherMiddleName": null,
"OtherNamePrefix": null,
"OtherNameSuffix": null,
"OtherCredential": null,
"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "3237 W TRUMAN BLVD STE 100",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "JEFFERSON CITY",
"MailingAddressStateName": "MO",
"MailingAddressPostalCode": "65109-6944",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": null,
"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "3237 W TRUMAN BLVD STE 100",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "JEFFERSON CITY",
"PracticeLocationAddressStateName": "MO",
"PracticeLocationAddressPostalCode": "65109-6944",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "573-635-0062",
"PracticeLocationAddressFaxNumber": null,
"EnumerationDate": "07/06/2015",
"LastUpdateDate": "04/21/2023",
"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": "2014041515",
"LicenseNumberStateCode": "MO",
"PrimaryTaxonomySwitch": "N"
},
{
"TaxonomyCode": "111N00000X",
"TaxonomyName": "Chiropractor",
"LicenseNumber": "2023009810",
"LicenseNumberStateCode": "MO",
"PrimaryTaxonomySwitch": "Y"
}
]
},
"HealthcareProviderTaxonomyGroups": null
}
}