{
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"EIN": null,
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"IsOrgSubpart": "N",
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"OrgName": "JEREMY HEDGES MD, MPH, LLC",
"LastName": null,
"FirstName": null,
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"FirstLineMailingAddress": "1183 SAINT PAUL ST",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "DENVER",
"MailingAddressStateName": "CO",
"MailingAddressPostalCode": "80206-3347",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": null,
"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "1715 N WEBER ST STE 220",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "COLORADO SPRINGS",
"PracticeLocationAddressStateName": "CO",
"PracticeLocationAddressPostalCode": "80907-7553",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "719-471-3246",
"PracticeLocationAddressFaxNumber": null,
"EnumerationDate": "05/24/2012",
"LastUpdateDate": "05/24/2012",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "HEDGES",
"AuthorizedOfficialFirstName": "JEREMY",
"AuthorizedOfficialMiddleName": null,
"AuthorizedOfficialTitle": "SOLO PRACTIONER",
"AuthorizedOfficialNamePrefix": "DR.",
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "MD, MPH",
"AuthorizedOfficialTelephoneNumber": "303-589-5720",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "208600000X",
"TaxonomyName": "Surgery Physician",
"LicenseNumber": "46906",
"LicenseNumberStateCode": "CO",
"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."
}
}
}
}