{
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"IsSoleProprietor": null,
"IsOrgSubpart": "N",
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"OrgName": "CARBON PODIATRY ASSOCIATES, INC.",
"LastName": null,
"FirstName": null,
"MiddleName": null,
"NamePrefix": null,
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"Credential": null,
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"OtherCredential": null,
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"FirstLineMailingAddress": "181 S 2ND ST",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "LEHIGHTON",
"MailingAddressStateName": "PA",
"MailingAddressPostalCode": "18235-2054",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "610-377-2490",
"MailingAddressFaxNumber": "610-377-9201",
"FirstLinePracticeLocationAddress": "181 S 2ND ST",
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"PracticeLocationAddressCityName": "LEHIGHTON",
"PracticeLocationAddressStateName": "PA",
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"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "610-377-2490",
"PracticeLocationAddressFaxNumber": "610-377-9201",
"EnumerationDate": "09/06/2006",
"LastUpdateDate": "06/30/2008",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "MERTZ",
"AuthorizedOfficialFirstName": "MATTHEW",
"AuthorizedOfficialMiddleName": "OWEN",
"AuthorizedOfficialTitle": "VICE PRESIDENT",
"AuthorizedOfficialNamePrefix": "DR.",
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "DPM",
"AuthorizedOfficialTelephoneNumber": "610-377-2490",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "213ES0103X",
"TaxonomyName": "Foot & Ankle Surgery Podiatrist",
"LicenseNumber": null,
"LicenseNumberStateCode": null,
"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."
}
}
}
}