{
"Npi": {
"NPI": "1861382434",
"EntityType": "Individual",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": "Y",
"IsOrgSubpart": null,
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": null,
"LastName": "BASCOM",
"FirstName": "RICKIE",
"MiddleName": null,
"NamePrefix": null,
"NameSuffix": null,
"Credential": "MPT",
"OtherOrgName": null,
"OtherOrgNameTypeCode": null,
"OtherLastName": null,
"OtherFirstName": null,
"OtherMiddleName": null,
"OtherNamePrefix": null,
"OtherNameSuffix": null,
"OtherCredential": null,
"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "819 N FATTIG CREEK RD",
"SecondLineMailingAddress": "BASCOM4EVER@MSN.COM",
"MailingAddressCityName": "ROUNDUP",
"MailingAddressStateName": "MT",
"MailingAddressPostalCode": "59072",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "801-668-4828",
"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "1807 24TH ST W",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "BILLINGS",
"PracticeLocationAddressStateName": "MT",
"PracticeLocationAddressPostalCode": "59102-2850",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "406-656-5010",
"PracticeLocationAddressFaxNumber": null,
"EnumerationDate": "07/07/2025",
"LastUpdateDate": "07/07/2025",
"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": "2251G0304X",
"TaxonomyName": "Geriatric Physical Therapist",
"LicenseNumber": "27314",
"LicenseNumberStateCode": "MT",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}