{
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"FirstLineMailingAddress": "12500 W 58TH AVE",
"SecondLineMailingAddress": "SUITE 233",
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"MailingAddressStateName": "CO",
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"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "720-536-5282",
"MailingAddressFaxNumber": "720-596-4364",
"FirstLinePracticeLocationAddress": "7917 S SETTLERS DR",
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"PracticeLocationAddressCityName": "MORRISON",
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"EnumerationDate": "01/07/2014",
"LastUpdateDate": "01/07/2014",
"NPIDeactivationReasonCode": null,
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"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
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"AuthorizedOfficialLastName": "MATHAD",
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"AuthorizedOfficialTitle": "CEO",
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"AuthorizedOfficialCredential": "M.D",
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"Taxonomies": {
"Taxonomy": {
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"TaxonomyName": "Pediatrics Physician",
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"LicenseNumberStateCode": "CO",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": {
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"HealthcareProviderTaxonomyGroupDescription": "Single Specialty Group - A business group of one or more individual practitioners, all of who practice with the same area of specialization."
}
}
}
}