{
"Npi": {
"NPI": "1922331420",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "MAGUIRE BOONSTRA INC",
"LastName": null,
"FirstName": null,
"MiddleName": null,
"NamePrefix": null,
"NameSuffix": null,
"Credential": null,
"OtherOrgName": null,
"OtherOrgNameTypeCode": "6",
"OtherLastName": null,
"OtherFirstName": null,
"OtherMiddleName": null,
"OtherNamePrefix": null,
"OtherNameSuffix": null,
"OtherCredential": null,
"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "355 W ANCHOR DR",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "DAKOTA DUNES",
"MailingAddressStateName": "SD",
"MailingAddressPostalCode": "57049-5357",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "605-232-0066",
"MailingAddressFaxNumber": "605-232-2066",
"FirstLinePracticeLocationAddress": "355 W ANCHOR DR",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "DAKOTA DUNES",
"PracticeLocationAddressStateName": "SD",
"PracticeLocationAddressPostalCode": "57049-5357",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "605-232-0066",
"PracticeLocationAddressFaxNumber": "605-232-2066",
"EnumerationDate": "09/15/2009",
"LastUpdateDate": "01/03/2012",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "BOONSTRA",
"AuthorizedOfficialFirstName": "JEFF",
"AuthorizedOfficialMiddleName": "MADIGAN",
"AuthorizedOfficialTitle": "PRESIDENT/PROSTHETIST",
"AuthorizedOfficialNamePrefix": "MR.",
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "CP",
"AuthorizedOfficialTelephoneNumber": "605-232-0066",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "335E00000X",
"TaxonomyName": "Prosthetic/Orthotic Supplier",
"LicenseNumber": null,
"LicenseNumberStateCode": null,
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}