{
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"IsOrgSubpart": "N",
"ParentOrgLBN": null,
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"OrgName": "GENERATIONS FOOT AND ANKLE CLINIC",
"LastName": null,
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"MiddleName": null,
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"OtherCredential": null,
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"FirstLineMailingAddress": "3833 COON RAPIDS BLVD NW",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "COON RAPIDS",
"MailingAddressStateName": "MN",
"MailingAddressPostalCode": "55433-2643",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "763-422-0233",
"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "3833 COON RAPIDS BLVD NW",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "COON RAPIDS",
"PracticeLocationAddressStateName": "MN",
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"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "763-422-0233",
"PracticeLocationAddressFaxNumber": null,
"EnumerationDate": "08/16/2013",
"LastUpdateDate": "08/16/2013",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "WHITTAKER",
"AuthorizedOfficialFirstName": "SARAH",
"AuthorizedOfficialMiddleName": "P",
"AuthorizedOfficialTitle": "OWNER/PROVIDER",
"AuthorizedOfficialNamePrefix": null,
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "DPM",
"AuthorizedOfficialTelephoneNumber": "612-670-0209",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "213ES0103X",
"TaxonomyName": "Foot & Ankle Surgery Podiatrist",
"LicenseNumber": "830",
"LicenseNumberStateCode": "MN",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": {
"HealthcareProviderTaxonomyGroup": {
"HealthcareProviderTaxonomyGroupName": "193400000X 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."
}
}
}
}