{
"Npi": {
"NPI": "1215083035",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "RICHARD R. TAVERNETTI, 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": "2100 WEBSTER ST",
"SecondLineMailingAddress": "SUITE 115",
"MailingAddressCityName": "SAN FRANCISCO",
"MailingAddressStateName": "CA",
"MailingAddressPostalCode": "94115-2373",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "415-923-3033",
"MailingAddressFaxNumber": "415-923-3083",
"FirstLinePracticeLocationAddress": "2100 WEBSTER ST",
"SecondLinePracticeLocationAddress": "SUITE 115",
"PracticeLocationAddressCityName": "SAN FRANCISCO",
"PracticeLocationAddressStateName": "CA",
"PracticeLocationAddressPostalCode": "94115-2373",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "415-923-3033",
"PracticeLocationAddressFaxNumber": "415-923-3083",
"EnumerationDate": "01/26/2007",
"LastUpdateDate": "04/09/2008",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "TAVERNETTI",
"AuthorizedOfficialFirstName": "RICHARD",
"AuthorizedOfficialMiddleName": "ROLAND",
"AuthorizedOfficialTitle": "OWNER",
"AuthorizedOfficialNamePrefix": "DR.",
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "M.D.",
"AuthorizedOfficialTelephoneNumber": "415-923-3033",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "207XS0114X",
"TaxonomyName": "Adult Reconstructive Orthopaedic Surgery Physician",
"LicenseNumber": "A23135",
"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."
}
}
}
}