{
"Npi": {
"NPI": "1104997527",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "LOW COUNTRY FAMILY PODIATRY",
"LastName": null,
"FirstName": null,
"MiddleName": null,
"NamePrefix": null,
"NameSuffix": null,
"Credential": null,
"OtherOrgName": null,
"OtherOrgNameTypeCode": null,
"OtherLastName": null,
"OtherFirstName": null,
"OtherMiddleName": null,
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"OtherNameSuffix": null,
"OtherCredential": null,
"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "9313 MEDICAL PLAZA DR",
"SecondLineMailingAddress": "SUITE 301",
"MailingAddressCityName": "N CHARLESTON",
"MailingAddressStateName": "SC",
"MailingAddressPostalCode": "29406-9155",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "843-553-2909",
"MailingAddressFaxNumber": "843-553-4684",
"FirstLinePracticeLocationAddress": "9313 MEDICAL PLAZA DR",
"SecondLinePracticeLocationAddress": "SUITE 301",
"PracticeLocationAddressCityName": "N CHARLESTON",
"PracticeLocationAddressStateName": "SC",
"PracticeLocationAddressPostalCode": "29406-9155",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "843-553-2909",
"PracticeLocationAddressFaxNumber": "843-553-4684",
"EnumerationDate": "11/10/2006",
"LastUpdateDate": "11/20/2008",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "BLITCH",
"AuthorizedOfficialFirstName": "EDWIN",
"AuthorizedOfficialMiddleName": null,
"AuthorizedOfficialTitle": "PARTNER",
"AuthorizedOfficialNamePrefix": "DR.",
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "DPM",
"AuthorizedOfficialTelephoneNumber": "843-553-2909",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "213ES0103X",
"TaxonomyName": "Foot & Ankle Surgery Podiatrist",
"LicenseNumber": "134",
"LicenseNumberStateCode": "SC",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": {
"HealthcareProviderTaxonomyGroup": {
"HealthcareProviderTaxonomyGroupName": "193400000X SINGLE SPECIALTY GROUP",
"HealthcareProviderTaxonomyGroupDescription": "Single Specialty Group - A business group of one or more individual practitioners, all of who practice with the same area of specialization."
}
}
}
}