{
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"IsOrgSubpart": "N",
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"OrgName": "ADVANCED FOOT AND ANKLE SPECIALISTS, INC.",
"LastName": null,
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"MiddleName": null,
"NamePrefix": null,
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"FirstLineMailingAddress": "42-335 WASHINGTON F-338",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "PALM DESERT",
"MailingAddressStateName": "CA",
"MailingAddressPostalCode": "92211",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "760-674-3355",
"MailingAddressFaxNumber": "760-771-5149",
"FirstLinePracticeLocationAddress": "78-437 HWY 111",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "LA QUINTA",
"PracticeLocationAddressStateName": "CA",
"PracticeLocationAddressPostalCode": "92253",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "760-674-3355",
"PracticeLocationAddressFaxNumber": "760-771-5149",
"EnumerationDate": "01/21/2008",
"LastUpdateDate": "05/06/2013",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "SHRUM",
"AuthorizedOfficialFirstName": "DALE",
"AuthorizedOfficialMiddleName": null,
"AuthorizedOfficialTitle": "CEO",
"AuthorizedOfficialNamePrefix": "DR.",
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "DPM",
"AuthorizedOfficialTelephoneNumber": "760-674-3355",
"Taxonomies": {
"Taxonomy": [
{
"TaxonomyCode": "213ES0103X",
"TaxonomyName": "Foot & Ankle Surgery Podiatrist",
"LicenseNumber": "E3589",
"LicenseNumberStateCode": "CA",
"PrimaryTaxonomySwitch": "N"
},
{
"TaxonomyCode": "213E00000X",
"TaxonomyName": "Podiatrist",
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"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."
}
]
}
}
}