{
"Npi": {
"NPI": "1174559579",
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"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "SEDALIA FOOT CLINIC PC",
"LastName": null,
"FirstName": null,
"MiddleName": null,
"NamePrefix": null,
"NameSuffix": null,
"Credential": null,
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"OtherOrgNameTypeCode": null,
"OtherLastName": null,
"OtherFirstName": null,
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"OtherCredential": null,
"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "519 E 13TH ST",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "SEDALIA",
"MailingAddressStateName": "MO",
"MailingAddressPostalCode": "65301-5909",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "660-826-5897",
"MailingAddressFaxNumber": "660-826-4691",
"FirstLinePracticeLocationAddress": "519 E 13TH ST",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "SEDALIA",
"PracticeLocationAddressStateName": "MO",
"PracticeLocationAddressPostalCode": "65301-5909",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "660-826-5897",
"PracticeLocationAddressFaxNumber": "660-826-4691",
"EnumerationDate": "06/25/2006",
"LastUpdateDate": "06/23/2015",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "BROWN",
"AuthorizedOfficialFirstName": "PAULA",
"AuthorizedOfficialMiddleName": "A",
"AuthorizedOfficialTitle": "OFFICE MANAGER",
"AuthorizedOfficialNamePrefix": "MRS.",
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": null,
"AuthorizedOfficialTelephoneNumber": "660-826-5897",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "213ES0131X",
"TaxonomyName": "Foot Surgery Podiatrist",
"LicenseNumber": "000587",
"LicenseNumberStateCode": "MO",
"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."
}
}
}
}