{
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"FirstLineMailingAddress": "9351 GRANT STREET",
"SecondLineMailingAddress": "SUITE 490",
"MailingAddressCityName": "THORNTON",
"MailingAddressStateName": "CO",
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"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "303-451-5271",
"MailingAddressFaxNumber": "303-452-4398",
"FirstLinePracticeLocationAddress": "9351 GRANT ST",
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"PracticeLocationAddressCityName": "THORNTON",
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"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "303-451-5271",
"PracticeLocationAddressFaxNumber": "303-452-4398",
"EnumerationDate": "09/18/2012",
"LastUpdateDate": "09/18/2012",
"NPIDeactivationReasonCode": null,
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"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "DAVIS",
"AuthorizedOfficialFirstName": "JAMES",
"AuthorizedOfficialMiddleName": "D",
"AuthorizedOfficialTitle": "OWNER",
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"AuthorizedOfficialCredential": "DPM",
"AuthorizedOfficialTelephoneNumber": "303-451-5271",
"Taxonomies": {
"Taxonomy": [
{
"TaxonomyCode": "213ES0103X",
"TaxonomyName": "Foot & Ankle Surgery Podiatrist",
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"LicenseNumberStateCode": "CO",
"PrimaryTaxonomySwitch": "N"
},
{
"TaxonomyCode": "213ES0103X",
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}
]
},
"HealthcareProviderTaxonomyGroups": {
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{
"HealthcareProviderTaxonomyGroupName": "193400000X MULTIPLE 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."
},
{
"HealthcareProviderTaxonomyGroupName": "193400000X MULTIPLE 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."
}
]
}
}
}