{
"Npi": {
"NPI": "1518221779",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "MINNESOTA WOMEN'S CARE, P.A.",
"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": "2603 WHITE BEAR AVE N",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "MAPLEWOOD",
"MailingAddressStateName": "MN",
"MailingAddressPostalCode": "55109-5110",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "651-600-3035",
"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "2603 WHITE BEAR AVENUE NOTH",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "MAPLWOOD",
"PracticeLocationAddressStateName": "MN",
"PracticeLocationAddressPostalCode": "55109-8767",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "651-600-3035",
"PracticeLocationAddressFaxNumber": null,
"EnumerationDate": "07/02/2012",
"LastUpdateDate": "12/12/2016",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "ASHFORD",
"AuthorizedOfficialFirstName": "MELVIN",
"AuthorizedOfficialMiddleName": null,
"AuthorizedOfficialTitle": "MEDICAL DIRECTOR",
"AuthorizedOfficialNamePrefix": "DR.",
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "MD",
"AuthorizedOfficialTelephoneNumber": "651-600-3035",
"Taxonomies": {
"Taxonomy": [
{
"TaxonomyCode": "207VF0040X",
"TaxonomyName": "Urogynecology and Reconstructive Pelvic Surgery (Obstetrics & Gynecology) Physician",
"LicenseNumber": null,
"LicenseNumberStateCode": null,
"PrimaryTaxonomySwitch": "N"
},
{
"TaxonomyCode": "332B00000X",
"TaxonomyName": "Durable Medical Equipment & Medical Supplies",
"LicenseNumber": null,
"LicenseNumberStateCode": "MN",
"PrimaryTaxonomySwitch": "N"
},
{
"TaxonomyCode": "207V00000X",
"TaxonomyName": "Obstetrics & Gynecology Physician",
"LicenseNumber": "1841",
"LicenseNumberStateCode": "MN",
"PrimaryTaxonomySwitch": "Y"
}
]
},
"HealthcareProviderTaxonomyGroups": {
"HealthcareProviderTaxonomyGroup": [
{
"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."
}
]
}
}
}