{
"Npi": {
"NPI": "1225082977",
"EntityType": "Individual",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": "Y",
"IsOrgSubpart": null,
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": null,
"LastName": "BEAUDREAU",
"FirstName": "JENNIFER",
"MiddleName": null,
"NamePrefix": null,
"NameSuffix": null,
"Credential": "MD",
"OtherOrgName": null,
"OtherOrgNameTypeCode": null,
"OtherLastName": null,
"OtherFirstName": null,
"OtherMiddleName": null,
"OtherNamePrefix": null,
"OtherNameSuffix": null,
"OtherCredential": null,
"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "PO BOX 1399",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "EVANS",
"MailingAddressStateName": "GA",
"MailingAddressPostalCode": "30809-1399",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "706-447-1280",
"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "1350 WALTON WAY",
"SecondLinePracticeLocationAddress": "EMERGENCY DEPT UNIVERSITY HOSPITAL",
"PracticeLocationAddressCityName": "AUGUSTA",
"PracticeLocationAddressStateName": "GA",
"PracticeLocationAddressPostalCode": "30901-2612",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "706-774-2223",
"PracticeLocationAddressFaxNumber": null,
"EnumerationDate": "05/19/2006",
"LastUpdateDate": "03/19/2008",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": "F",
"Gender": "Female",
"AuthorizedOfficialLastName": null,
"AuthorizedOfficialFirstName": null,
"AuthorizedOfficialMiddleName": null,
"AuthorizedOfficialTitle": null,
"AuthorizedOfficialNamePrefix": null,
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": null,
"AuthorizedOfficialTelephoneNumber": null,
"Taxonomies": {
"Taxonomy": [
{
"TaxonomyCode": "208000000X",
"TaxonomyName": "Pediatrics Physician",
"LicenseNumber": "31002",
"LicenseNumberStateCode": "AZ",
"PrimaryTaxonomySwitch": "Y"
},
{
"TaxonomyCode": "208M00000X",
"TaxonomyName": "Hospitalist Physician",
"LicenseNumber": "31002",
"LicenseNumberStateCode": "AZ",
"PrimaryTaxonomySwitch": "N"
}
]
},
"HealthcareProviderTaxonomyGroups": null
}
}