{
"Npi": {
"NPI": "1922214246",
"EntityType": "Individual",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": "N",
"IsOrgSubpart": null,
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": null,
"LastName": "NADAREVIC",
"FirstName": "DEBORAH",
"MiddleName": null,
"NamePrefix": "MRS.",
"NameSuffix": null,
"Credential": "R.PH.",
"OtherOrgName": null,
"OtherOrgNameTypeCode": null,
"OtherLastName": "SMITH",
"OtherFirstName": "DEBORAH",
"OtherMiddleName": null,
"OtherNamePrefix": null,
"OtherNameSuffix": null,
"OtherCredential": null,
"OtherLastNameTypeCode": "1",
"FirstLineMailingAddress": "3801 STONEBRIDGE ROAD",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "WEST DES MOINES",
"MailingAddressStateName": "IA",
"MailingAddressPostalCode": "50265",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "515-975-1731",
"MailingAddressFaxNumber": "641-872-2031",
"FirstLinePracticeLocationAddress": "YOUR NEIGHBORHOOD PHARMACY",
"SecondLinePracticeLocationAddress": "510 E. JEFFERSON STREET SUITE A",
"PracticeLocationAddressCityName": "CORYDON",
"PracticeLocationAddressStateName": "IA",
"PracticeLocationAddressPostalCode": "50060",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "641-872-2030",
"PracticeLocationAddressFaxNumber": "641-872-2031",
"EnumerationDate": "05/15/2007",
"LastUpdateDate": "06/09/2020",
"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": "183500000X",
"TaxonomyName": "Pharmacist",
"LicenseNumber": "17485",
"LicenseNumberStateCode": "IA",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}