{
"Npi": {
"NPI": "1902241110",
"EntityType": "Individual",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": "N",
"IsOrgSubpart": null,
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": null,
"LastName": "CARR",
"FirstName": "JENNIFER",
"MiddleName": "BERNICE",
"NamePrefix": null,
"NameSuffix": null,
"Credential": "N.P.",
"OtherOrgName": null,
"OtherOrgNameTypeCode": null,
"OtherLastName": "FERGUSON",
"OtherFirstName": "JENNIFER",
"OtherMiddleName": null,
"OtherNamePrefix": null,
"OtherNameSuffix": null,
"OtherCredential": null,
"OtherLastNameTypeCode": "1",
"FirstLineMailingAddress": "23240 CAHUILLA RD",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "APPLE VALLEY",
"MailingAddressStateName": "CA",
"MailingAddressPostalCode": "92307-1906",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "661-809-2336",
"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "16850 BEAR VALLEY RD",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "VICTORVILLE",
"PracticeLocationAddressStateName": "CA",
"PracticeLocationAddressPostalCode": "92395-5794",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "760-241-8000",
"PracticeLocationAddressFaxNumber": null,
"EnumerationDate": "05/01/2013",
"LastUpdateDate": "10/22/2021",
"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": "163WG0000X",
"TaxonomyName": "General Practice Registered Nurse",
"LicenseNumber": "585346",
"LicenseNumberStateCode": "CA",
"PrimaryTaxonomySwitch": "N"
},
{
"TaxonomyCode": "363LF0000X",
"TaxonomyName": "Family Nurse Practitioner",
"LicenseNumber": "95000100",
"LicenseNumberStateCode": "CA",
"PrimaryTaxonomySwitch": "Y"
}
]
},
"HealthcareProviderTaxonomyGroups": null
}
}