{
"Npi": {
"NPI": "1639220189",
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"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "NORTH BAY MEDICAL GROUP SURGERY CENTER",
"LastName": null,
"FirstName": null,
"MiddleName": null,
"NamePrefix": null,
"NameSuffix": null,
"Credential": null,
"OtherOrgName": null,
"OtherOrgNameTypeCode": null,
"OtherLastName": null,
"OtherFirstName": null,
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"OtherNameSuffix": null,
"OtherCredential": null,
"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "3850 MONTGOMERY DR",
"SecondLineMailingAddress": "SUITE D",
"MailingAddressCityName": "SANTA ROSA",
"MailingAddressStateName": "CA",
"MailingAddressPostalCode": "95405-5207",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "707-591-0619",
"MailingAddressFaxNumber": "707-591-0617",
"FirstLinePracticeLocationAddress": "4415 SONOMA HWY",
"SecondLinePracticeLocationAddress": "SUITE B",
"PracticeLocationAddressCityName": "SANTA ROSA",
"PracticeLocationAddressStateName": "CA",
"PracticeLocationAddressPostalCode": "95409-7100",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "707-591-0619",
"PracticeLocationAddressFaxNumber": "707-591-0617",
"EnumerationDate": "01/12/2007",
"LastUpdateDate": "07/21/2008",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "KRAUT",
"AuthorizedOfficialFirstName": "ERIC",
"AuthorizedOfficialMiddleName": "JAMES",
"AuthorizedOfficialTitle": "PRESIDENT",
"AuthorizedOfficialNamePrefix": null,
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "M.D.",
"AuthorizedOfficialTelephoneNumber": "707-591-0619",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "261QA1903X",
"TaxonomyName": "Ambulatory Surgical Clinic/Center",
"LicenseNumber": "AS1628",
"LicenseNumberStateCode": "CA",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}