{
"Npi": {
"NPI": "1841879335",
"EntityType": "Individual",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": "Y",
"IsOrgSubpart": null,
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": null,
"LastName": "LYNCH",
"FirstName": "ELIZABETH",
"MiddleName": null,
"NamePrefix": null,
"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 358",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "CROWNPOINT",
"MailingAddressStateName": "NM",
"MailingAddressPostalCode": "87313-0358",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "505-786-6302",
"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "CROWNPOINT HEALTHCARE FACILITY",
"SecondLinePracticeLocationAddress": "JUNCTION RD. 371 ROUTE 9",
"PracticeLocationAddressCityName": "CROWNPOINT",
"PracticeLocationAddressStateName": "NM",
"PracticeLocationAddressPostalCode": "87313",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "505-272-2111",
"PracticeLocationAddressFaxNumber": null,
"EnumerationDate": "04/03/2021",
"LastUpdateDate": "11/08/2024",
"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": "207P00000X",
"TaxonomyName": "Emergency Medicine Physician",
"LicenseNumber": "MD2024-0216",
"LicenseNumberStateCode": "NM",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": {
"HealthcareProviderTaxonomyGroup": {
"HealthcareProviderTaxonomyGroupName": "193400000X SINGLE SPECIALTY GROUP",
"HealthcareProviderTaxonomyGroupDescription": "Single Specialty Group - A business group of one or more individual practitioners, all of who practice with the same area of specialization."
}
}
}
}