{
"Npi": {
"NPI": "1285863183",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "HAYDEN FAMILY FOOT AND ANKLE CLINIC, PLLC",
"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": "8944 N HESS ST",
"SecondLineMailingAddress": "SUITE A",
"MailingAddressCityName": "HAYDEN",
"MailingAddressStateName": "ID",
"MailingAddressPostalCode": "83835-9183",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "208-762-0909",
"MailingAddressFaxNumber": "888-762-0909",
"FirstLinePracticeLocationAddress": "8944 N HESS ST",
"SecondLinePracticeLocationAddress": "SUITE A",
"PracticeLocationAddressCityName": "HAYDEN",
"PracticeLocationAddressStateName": "ID",
"PracticeLocationAddressPostalCode": "83835-9183",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "208-762-0909",
"PracticeLocationAddressFaxNumber": "888-762-0909",
"EnumerationDate": "07/13/2009",
"LastUpdateDate": "08/12/2013",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "HIX",
"AuthorizedOfficialFirstName": "JOEL",
"AuthorizedOfficialMiddleName": "DANIEL",
"AuthorizedOfficialTitle": "OWNER",
"AuthorizedOfficialNamePrefix": "DR.",
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "D.P.M.",
"AuthorizedOfficialTelephoneNumber": "509-879-9029",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "261QP1100X",
"TaxonomyName": "Podiatric Clinic/Center",
"LicenseNumber": "P-200",
"LicenseNumberStateCode": "ID",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}