{
"Npi": {
"NPI": "1912194556",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "MATTHEW MCQUAID, DPM, INC.",
"LastName": null,
"FirstName": null,
"MiddleName": null,
"NamePrefix": null,
"NameSuffix": null,
"Credential": null,
"OtherOrgName": null,
"OtherOrgNameTypeCode": null,
"OtherLastName": null,
"OtherFirstName": null,
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"OtherNameSuffix": null,
"OtherCredential": null,
"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "5150 HILL RD E STE A",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "LAKEPORT",
"MailingAddressStateName": "CA",
"MailingAddressPostalCode": "95453-5100",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "707-263-3727",
"MailingAddressFaxNumber": "707-263-5236",
"FirstLinePracticeLocationAddress": "5150 HILL RD E STE A",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "LAKEPORT",
"PracticeLocationAddressStateName": "CA",
"PracticeLocationAddressPostalCode": "95453-5100",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "707-263-3727",
"PracticeLocationAddressFaxNumber": "707-263-5236",
"EnumerationDate": "09/27/2007",
"LastUpdateDate": "04/11/2011",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "MCQUAID",
"AuthorizedOfficialFirstName": "MATTHEW",
"AuthorizedOfficialMiddleName": null,
"AuthorizedOfficialTitle": "PRESIDENT",
"AuthorizedOfficialNamePrefix": null,
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "DPM",
"AuthorizedOfficialTelephoneNumber": "707-263-3727",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "213ES0103X",
"TaxonomyName": "Foot & Ankle Surgery Podiatrist",
"LicenseNumber": "E3998",
"LicenseNumberStateCode": "CA",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": {
"HealthcareProviderTaxonomyGroup": {
"HealthcareProviderTaxonomyGroupName": "193200000X MULTI-SPECIALTY GROUP",
"HealthcareProviderTaxonomyGroupDescription": "Multi-Specialty Group - A business group of one or more individual practitioners, who practice with different areas of specialization."
}
}
}
}