{
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"EIN": null,
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"IsOrgSubpart": "N",
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"OrgName": "WINDWARD PEDIATRICS, INC.",
"LastName": null,
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"NamePrefix": null,
"NameSuffix": null,
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"FirstLineMailingAddress": "45-710 KAMEHAMEHA HWY",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "KANEOHE",
"MailingAddressStateName": "HI",
"MailingAddressPostalCode": "96744-2947",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "808-247-6644",
"MailingAddressFaxNumber": "808-235-2566",
"FirstLinePracticeLocationAddress": "45-710 KAMEHAMEHA HWY",
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"PracticeLocationAddressCityName": "KANEOHE",
"PracticeLocationAddressStateName": "HI",
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"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "808-247-6644",
"PracticeLocationAddressFaxNumber": "808-235-2566",
"EnumerationDate": "07/17/2006",
"LastUpdateDate": "11/15/2007",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "YIM",
"AuthorizedOfficialFirstName": "GREGORY",
"AuthorizedOfficialMiddleName": "KY",
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"AuthorizedOfficialCredential": "MD",
"AuthorizedOfficialTelephoneNumber": "808-247-6644",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "174400000X",
"TaxonomyName": "Specialist",
"LicenseNumber": "MD6927",
"LicenseNumberStateCode": "HI",
"PrimaryTaxonomySwitch": "Y"
}
},
"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."
}
}
}
}