{
"Npi": {
"NPI": "1215156120",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "JUDSON P SMITH MD PA",
"LastName": null,
"FirstName": null,
"MiddleName": null,
"NamePrefix": null,
"NameSuffix": null,
"Credential": null,
"OtherOrgName": null,
"OtherOrgNameTypeCode": "6",
"OtherLastName": null,
"OtherFirstName": null,
"OtherMiddleName": null,
"OtherNamePrefix": null,
"OtherNameSuffix": null,
"OtherCredential": null,
"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "417 W MAGNOLIA AVE",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "FORT WORTH",
"MailingAddressStateName": "TX",
"MailingAddressPostalCode": "76104",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "817-338-0875",
"MailingAddressFaxNumber": "817-870-1612",
"FirstLinePracticeLocationAddress": "417 W MAGNOLIA AVE",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "FORT WORTH",
"PracticeLocationAddressStateName": "TX",
"PracticeLocationAddressPostalCode": "76104",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "817-338-0875",
"PracticeLocationAddressFaxNumber": "817-870-1612",
"EnumerationDate": "04/25/2007",
"LastUpdateDate": "11/04/2010",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "FITZGERALD",
"AuthorizedOfficialFirstName": "LISA",
"AuthorizedOfficialMiddleName": "M",
"AuthorizedOfficialTitle": "OFFICE MANAGER",
"AuthorizedOfficialNamePrefix": "MRS.",
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": null,
"AuthorizedOfficialTelephoneNumber": "817-338-4081",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "174400000X",
"TaxonomyName": "Specialist",
"LicenseNumber": "D9667",
"LicenseNumberStateCode": "TX",
"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."
}
}
}
}