{
"Npi": {
"NPI": "1821159807",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "ROSS E. DICKSTEIN MDPC",
"LastName": null,
"FirstName": null,
"MiddleName": null,
"NamePrefix": null,
"NameSuffix": null,
"Credential": null,
"OtherOrgName": null,
"OtherOrgNameTypeCode": null,
"OtherLastName": null,
"OtherFirstName": null,
"OtherMiddleName": null,
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"OtherNameSuffix": null,
"OtherCredential": null,
"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "PO BOX 2044",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "SILVERTHORNE",
"MailingAddressStateName": "CO",
"MailingAddressPostalCode": "80498-2044",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "303-422-9438",
"MailingAddressFaxNumber": "303-422-9474",
"FirstLinePracticeLocationAddress": "340 PEAK ONE SURGERY CENTER",
"SecondLinePracticeLocationAddress": "COUNTY R",
"PracticeLocationAddressCityName": "FRISCO",
"PracticeLocationAddressStateName": "CO",
"PracticeLocationAddressPostalCode": "80443",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "303-422-9438",
"PracticeLocationAddressFaxNumber": "303-422-9474",
"EnumerationDate": "12/13/2006",
"LastUpdateDate": "04/20/2008",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "DICKSTEIN",
"AuthorizedOfficialFirstName": "ROSS",
"AuthorizedOfficialMiddleName": "E",
"AuthorizedOfficialTitle": "OWNER",
"AuthorizedOfficialNamePrefix": null,
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "M.D.",
"AuthorizedOfficialTelephoneNumber": "303-422-9438",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "207LP2900X",
"TaxonomyName": "Pain Medicine (Anesthesiology) Physician",
"LicenseNumber": "37335",
"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."
}
}
}
}