{
"Npi": {
"NPI": "1912043936",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "PEDIATRIC PARTNERS LLC",
"LastName": null,
"FirstName": null,
"MiddleName": null,
"NamePrefix": null,
"NameSuffix": null,
"Credential": null,
"OtherOrgName": null,
"OtherOrgNameTypeCode": null,
"OtherLastName": null,
"OtherFirstName": null,
"OtherMiddleName": null,
"OtherNamePrefix": null,
"OtherNameSuffix": null,
"OtherCredential": null,
"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "4C NORTH AVE",
"SecondLineMailingAddress": "SUITE 400",
"MailingAddressCityName": "BEL AIR",
"MailingAddressStateName": "MD",
"MailingAddressPostalCode": "21014-2330",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "410-638-0537",
"MailingAddressFaxNumber": "410-638-0282",
"FirstLinePracticeLocationAddress": "4C NORTH AVE STE 400",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "BEL AIR",
"PracticeLocationAddressStateName": "MD",
"PracticeLocationAddressPostalCode": "21014-2333",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "410-638-0239",
"PracticeLocationAddressFaxNumber": "410-638-0282",
"EnumerationDate": "01/29/2007",
"LastUpdateDate": "10/15/2024",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "SEYMOUR",
"AuthorizedOfficialFirstName": "KEVIN",
"AuthorizedOfficialMiddleName": null,
"AuthorizedOfficialTitle": "PRESIDENT PEDIATRICIAN",
"AuthorizedOfficialNamePrefix": "DR.",
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "M.D.",
"AuthorizedOfficialTelephoneNumber": "410-638-0537",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "2080A0000X",
"TaxonomyName": "Pediatric Adolescent Medicine Physician",
"LicenseNumber": "D0028122",
"LicenseNumberStateCode": "MD",
"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."
}
}
}
}