{
"Npi": {
"NPI": "1811519515",
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"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "COLLINS PODIATRY CORPORATION",
"LastName": null,
"FirstName": null,
"MiddleName": null,
"NamePrefix": null,
"NameSuffix": null,
"Credential": null,
"OtherOrgName": null,
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"OtherLastName": null,
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"OtherCredential": null,
"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "12221 TAYLOR CT",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "WEST WINDSOR",
"MailingAddressStateName": "NJ",
"MailingAddressPostalCode": "08550-5372",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "918-327-3282",
"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "1223 GRANT AVE STE D",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "NOVATO",
"PracticeLocationAddressStateName": "CA",
"PracticeLocationAddressPostalCode": "94945-3157",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "918-327-3282",
"PracticeLocationAddressFaxNumber": null,
"EnumerationDate": "05/15/2020",
"LastUpdateDate": "05/15/2020",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "COLLINS",
"AuthorizedOfficialFirstName": "ADAM",
"AuthorizedOfficialMiddleName": null,
"AuthorizedOfficialTitle": "PRESIDENT",
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"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "DPM",
"AuthorizedOfficialTelephoneNumber": "918-327-3282",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "261QP1100X",
"TaxonomyName": "Podiatric Clinic/Center",
"LicenseNumber": null,
"LicenseNumberStateCode": null,
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}