{
"Npi": {
"NPI": "1861610743",
"EntityType": "Individual",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": "Y",
"IsOrgSubpart": null,
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": null,
"LastName": "LIPPE",
"FirstName": "JULIENNE",
"MiddleName": null,
"NamePrefix": "DR.",
"NameSuffix": null,
"Credential": "MD",
"OtherOrgName": null,
"OtherOrgNameTypeCode": null,
"OtherLastName": "BOONE",
"OtherFirstName": "JULIENNE",
"OtherMiddleName": "LIPPE",
"OtherNamePrefix": null,
"OtherNameSuffix": null,
"OtherCredential": "M.D.",
"OtherLastNameTypeCode": "1",
"FirstLineMailingAddress": "308 LOUISIANA AVE STE 2",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "LIBBY",
"MailingAddressStateName": "MT",
"MailingAddressPostalCode": "59923-2159",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "406-283-6824",
"MailingAddressFaxNumber": "406-283-3022",
"FirstLinePracticeLocationAddress": "308 LOUISIANA AVE STE 2",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "LIBBY",
"PracticeLocationAddressStateName": "MT",
"PracticeLocationAddressPostalCode": "59923-2159",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "406-283-6824",
"PracticeLocationAddressFaxNumber": "406-283-3022",
"EnumerationDate": "04/23/2007",
"LastUpdateDate": "08/03/2023",
"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": "207XX0005X",
"TaxonomyName": "Sports Medicine (Orthopaedic Surgery) Physician",
"LicenseNumber": "2011016774",
"LicenseNumberStateCode": "MO",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}