{
"Npi": {
"NPI": "1205029402",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "SUSAN E. ZIEMBA, M.D., INC.",
"LastName": null,
"FirstName": null,
"MiddleName": null,
"NamePrefix": null,
"NameSuffix": null,
"Credential": null,
"OtherOrgName": null,
"OtherOrgNameTypeCode": null,
"OtherLastName": null,
"OtherFirstName": null,
"OtherMiddleName": null,
"OtherNamePrefix": null,
"OtherNameSuffix": null,
"OtherCredential": null,
"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "1510 E MAIN ST",
"SecondLineMailingAddress": "STE 104C",
"MailingAddressCityName": "SANTA MARIA",
"MailingAddressStateName": "CA",
"MailingAddressPostalCode": "93454-4825",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "805-925-1624",
"MailingAddressFaxNumber": "805-925-3754",
"FirstLinePracticeLocationAddress": "1510 E MAIN ST",
"SecondLinePracticeLocationAddress": "STE 104C",
"PracticeLocationAddressCityName": "SANTA MARIA",
"PracticeLocationAddressStateName": "CA",
"PracticeLocationAddressPostalCode": "93454-4825",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "805-925-1624",
"PracticeLocationAddressFaxNumber": null,
"EnumerationDate": "08/21/2007",
"LastUpdateDate": "02/29/2012",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "ZIEMBA",
"AuthorizedOfficialFirstName": "SUSAN",
"AuthorizedOfficialMiddleName": null,
"AuthorizedOfficialTitle": "PRESIDENT",
"AuthorizedOfficialNamePrefix": null,
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "M.D.",
"AuthorizedOfficialTelephoneNumber": "805-925-1624",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "207R00000X",
"TaxonomyName": "Internal Medicine Physician",
"LicenseNumber": "G55745",
"LicenseNumberStateCode": "CA",
"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."
}
}
}
}