{
"Npi": {
"NPI": "1487910857",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "GEORGE K. MATHEW, M.D., INC.",
"LastName": null,
"FirstName": null,
"MiddleName": null,
"NamePrefix": null,
"NameSuffix": null,
"Credential": null,
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"OtherOrgNameTypeCode": null,
"OtherLastName": null,
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"OtherNamePrefix": null,
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"OtherCredential": null,
"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "29099 HEALTH CAMPUS DR",
"SecondLineMailingAddress": "SUITE #230",
"MailingAddressCityName": "WESTLAKE",
"MailingAddressStateName": "OH",
"MailingAddressPostalCode": "44145-5200",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "440-835-6263",
"MailingAddressFaxNumber": "440-892-6632",
"FirstLinePracticeLocationAddress": "29099 HEALTH CAMPUS DR",
"SecondLinePracticeLocationAddress": "SUITE #230",
"PracticeLocationAddressCityName": "WESTLAKE",
"PracticeLocationAddressStateName": "OH",
"PracticeLocationAddressPostalCode": "44145-5200",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "440-835-6263",
"PracticeLocationAddressFaxNumber": "440-892-6632",
"EnumerationDate": "04/10/2012",
"LastUpdateDate": "04/10/2012",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "MATHEW",
"AuthorizedOfficialFirstName": "GEORGE",
"AuthorizedOfficialMiddleName": "K",
"AuthorizedOfficialTitle": "PRESIDENT",
"AuthorizedOfficialNamePrefix": "DR.",
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "M.D.",
"AuthorizedOfficialTelephoneNumber": "440-835-6263",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "208D00000X",
"TaxonomyName": "General Practice Physician",
"LicenseNumber": "35-044841",
"LicenseNumberStateCode": "OH",
"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."
}
}
}
}