{
"Npi": {
"NPI": "1871799098",
"EntityType": "Individual",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": "N",
"IsOrgSubpart": null,
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": null,
"LastName": "MONTGOMERY",
"FirstName": "YVITA",
"MiddleName": "C.",
"NamePrefix": "MISS",
"NameSuffix": null,
"Credential": "B.S.",
"OtherOrgName": null,
"OtherOrgNameTypeCode": null,
"OtherLastName": "MONTGOMERY",
"OtherFirstName": "YVITA",
"OtherMiddleName": "C.",
"OtherNamePrefix": "MISS",
"OtherNameSuffix": null,
"OtherCredential": "B.S.",
"OtherLastNameTypeCode": "5",
"FirstLineMailingAddress": "757 W SEPULVEDA ST UNIT B",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "SAN PEDRO",
"MailingAddressStateName": "CA",
"MailingAddressPostalCode": "90731-1941",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "213-639-2689",
"MailingAddressFaxNumber": "213-389-1987",
"FirstLinePracticeLocationAddress": "2500 WILSHIRE BLVD",
"SecondLinePracticeLocationAddress": "7",
"PracticeLocationAddressCityName": "LOS ANGELES",
"PracticeLocationAddressStateName": "CA",
"PracticeLocationAddressPostalCode": "90057-4303",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "213-639-2689",
"PracticeLocationAddressFaxNumber": null,
"EnumerationDate": "06/25/2007",
"LastUpdateDate": "06/12/2013",
"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": "225400000X",
"TaxonomyName": "Rehabilitation Practitioner",
"LicenseNumber": null,
"LicenseNumberStateCode": null,
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}