{
"Npi": {
"NPI": "1861954919",
"EntityType": "Individual",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": "Y",
"IsOrgSubpart": null,
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": null,
"LastName": "YATES",
"FirstName": "CHRISTIN",
"MiddleName": "DENAY",
"NamePrefix": "MISS",
"NameSuffix": null,
"Credential": null,
"OtherOrgName": null,
"OtherOrgNameTypeCode": null,
"OtherLastName": "KIRBY",
"OtherFirstName": "CHRISTIN",
"OtherMiddleName": "DENAY",
"OtherNamePrefix": "MRS.",
"OtherNameSuffix": null,
"OtherCredential": null,
"OtherLastNameTypeCode": "1",
"FirstLineMailingAddress": "18525 W VAN BUREN ST",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "GOODYEAR",
"MailingAddressStateName": "AZ",
"MailingAddressPostalCode": "85338-5887",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "623-341-1169",
"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "435 N 5TH ST",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "PHOENIX",
"PracticeLocationAddressStateName": "AZ",
"PracticeLocationAddressPostalCode": "85004-2157",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "623-341-1169",
"PracticeLocationAddressFaxNumber": null,
"EnumerationDate": "04/05/2019",
"LastUpdateDate": "11/18/2019",
"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": "363A00000X",
"TaxonomyName": "Physician Assistant",
"LicenseNumber": "7609",
"LicenseNumberStateCode": "AZ",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}