{
"Npi": {
"NPI": "1184748717",
"EntityType": "Individual",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": "N",
"IsOrgSubpart": null,
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": null,
"LastName": "WELLMAN",
"FirstName": "SCOTT",
"MiddleName": "V.",
"NamePrefix": "DR.",
"NameSuffix": null,
"Credential": "DDS",
"OtherOrgName": null,
"OtherOrgNameTypeCode": null,
"OtherLastName": null,
"OtherFirstName": null,
"OtherMiddleName": null,
"OtherNamePrefix": null,
"OtherNameSuffix": null,
"OtherCredential": null,
"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "305 TISBURY CT",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "LEXINGTON",
"MailingAddressStateName": "SC",
"MailingAddressPostalCode": "29072-7748",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "623-910-0407",
"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "101 R L SAWYER MD DR",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "SALUDA",
"PracticeLocationAddressStateName": "SC",
"PracticeLocationAddressPostalCode": "29138-9199",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "864-445-8168",
"PracticeLocationAddressFaxNumber": null,
"EnumerationDate": "03/19/2007",
"LastUpdateDate": "12/06/2013",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": "M",
"Gender": "Male",
"AuthorizedOfficialLastName": null,
"AuthorizedOfficialFirstName": null,
"AuthorizedOfficialMiddleName": null,
"AuthorizedOfficialTitle": null,
"AuthorizedOfficialNamePrefix": null,
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": null,
"AuthorizedOfficialTelephoneNumber": null,
"Taxonomies": {
"Taxonomy": [
{
"TaxonomyCode": "122300000X",
"TaxonomyName": "Dentist",
"LicenseNumber": "8210",
"LicenseNumberStateCode": "SC",
"PrimaryTaxonomySwitch": "Y"
},
{
"TaxonomyCode": "1223G0001X",
"TaxonomyName": "General Practice Dentistry",
"LicenseNumber": "D6948",
"LicenseNumberStateCode": "AZ",
"PrimaryTaxonomySwitch": "N"
}
]
},
"HealthcareProviderTaxonomyGroups": null
}
}