{
"Npi": {
"NPI": "1326414558",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "SYNERGYHEALTH FOOT & ANKLE ASSOCIATES, 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": "14349 JUSTICE RD",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "MIDLOTHIAN",
"MailingAddressStateName": "VA",
"MailingAddressPostalCode": "23113-6841",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "804-837-4144",
"MailingAddressFaxNumber": "804-823-9335",
"FirstLinePracticeLocationAddress": "14349 JUSTICE RD",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "MIDLOTHIAN",
"PracticeLocationAddressStateName": "VA",
"PracticeLocationAddressPostalCode": "23113-6841",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "804-837-4144",
"PracticeLocationAddressFaxNumber": "804-823-9335",
"EnumerationDate": "08/11/2015",
"LastUpdateDate": "05/05/2023",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "VETTI",
"AuthorizedOfficialFirstName": "LUKE",
"AuthorizedOfficialMiddleName": "THOMAS PARKINSON",
"AuthorizedOfficialTitle": "PODIATRIST",
"AuthorizedOfficialNamePrefix": "DR.",
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "DPM",
"AuthorizedOfficialTelephoneNumber": "804-837-4144",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "213ES0103X",
"TaxonomyName": "Foot & Ankle Surgery Podiatrist",
"LicenseNumber": "0103301115",
"LicenseNumberStateCode": "VA",
"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."
}
}
}
}