{
"Npi": {
"NPI": "1225569528",
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"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "SUN CITY MEDICAL CENTER PLLC",
"LastName": null,
"FirstName": null,
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"NamePrefix": null,
"NameSuffix": null,
"Credential": null,
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"OtherOrgNameTypeCode": null,
"OtherLastName": null,
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"OtherCredential": null,
"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "9280 W SUNSET RD STE 410",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "LAS VEGAS",
"MailingAddressStateName": "NV",
"MailingAddressPostalCode": "89148-4862",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "702-300-8528",
"MailingAddressFaxNumber": "702-447-7544",
"FirstLinePracticeLocationAddress": "9280 W SUNSET RD STE 410",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "LAS VEGAS",
"PracticeLocationAddressStateName": "NV",
"PracticeLocationAddressPostalCode": "89148-4862",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "702-300-8528",
"PracticeLocationAddressFaxNumber": "702-447-7544",
"EnumerationDate": "03/27/2017",
"LastUpdateDate": "09/11/2019",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "BECK",
"AuthorizedOfficialFirstName": "GRANT",
"AuthorizedOfficialMiddleName": null,
"AuthorizedOfficialTitle": "OWNER/DOCTOR",
"AuthorizedOfficialNamePrefix": "DR.",
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "DPM",
"AuthorizedOfficialTelephoneNumber": "702-300-8528",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "213ES0103X",
"TaxonomyName": "Foot & Ankle Surgery Podiatrist",
"LicenseNumber": "0904",
"LicenseNumberStateCode": "NV",
"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."
}
}
}
}