{
"Npi": {
"NPI": "1437398112",
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"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "STEVEN P. MEDEIROS, D.O., INC.",
"LastName": null,
"FirstName": null,
"MiddleName": null,
"NamePrefix": null,
"NameSuffix": null,
"Credential": null,
"OtherOrgName": null,
"OtherOrgNameTypeCode": null,
"OtherLastName": null,
"OtherFirstName": null,
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"OtherNamePrefix": null,
"OtherNameSuffix": null,
"OtherCredential": null,
"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "PO BOX 1278",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "POTEAU",
"MailingAddressStateName": "OK",
"MailingAddressPostalCode": "74953-1278",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "918-635-3578",
"MailingAddressFaxNumber": "918-635-3479",
"FirstLinePracticeLocationAddress": "101 SMITH AVE",
"SecondLinePracticeLocationAddress": "STE 2",
"PracticeLocationAddressCityName": "POTEAU",
"PracticeLocationAddressStateName": "OK",
"PracticeLocationAddressPostalCode": "74953-2613",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "918-647-0670",
"PracticeLocationAddressFaxNumber": null,
"EnumerationDate": "02/19/2009",
"LastUpdateDate": "04/08/2014",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "MEDEIROS",
"AuthorizedOfficialFirstName": "STEVEN",
"AuthorizedOfficialMiddleName": "PAUL",
"AuthorizedOfficialTitle": "OWNER",
"AuthorizedOfficialNamePrefix": "DR.",
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "D.O.",
"AuthorizedOfficialTelephoneNumber": "918-635-3578",
"Taxonomies": {
"Taxonomy": [
{
"TaxonomyCode": "208600000X",
"TaxonomyName": "Surgery Physician",
"LicenseNumber": "2800",
"LicenseNumberStateCode": "OK",
"PrimaryTaxonomySwitch": "N"
},
{
"TaxonomyCode": "207Q00000X",
"TaxonomyName": "Family Medicine Physician",
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"PrimaryTaxonomySwitch": "Y"
}
]
},
"HealthcareProviderTaxonomyGroups": {
"HealthcareProviderTaxonomyGroup": [
{
"HealthcareProviderTaxonomyGroupName": "193200000X MULTI-SPECIALTY GROUP",
"HealthcareProviderTaxonomyGroupDescription": "Multi-Specialty Group - A business group of one or more individual practitioners, who practice with different areas of specialization."
},
{
"HealthcareProviderTaxonomyGroupName": "193200000X MULTI-SPECIALTY GROUP",
"HealthcareProviderTaxonomyGroupDescription": "Multi-Specialty Group - A business group of one or more individual practitioners, who practice with different areas of specialization."
}
]
}
}
}