{
"Npi": {
"NPI": "1255778189",
"EntityType": "Individual",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": "Y",
"IsOrgSubpart": null,
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": null,
"LastName": "FRIES",
"FirstName": "IAN",
"MiddleName": "BLAIR",
"NamePrefix": "DR.",
"NameSuffix": null,
"Credential": "M.D.",
"OtherOrgName": null,
"OtherOrgNameTypeCode": null,
"OtherLastName": null,
"OtherFirstName": null,
"OtherMiddleName": null,
"OtherNamePrefix": null,
"OtherNameSuffix": null,
"OtherCredential": null,
"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "1480 HIGHWAY A1A",
"SecondLineMailingAddress": "FRIES PROFESSIONAL BUILDING",
"MailingAddressCityName": "VERO BEACH",
"MailingAddressStateName": "FL",
"MailingAddressPostalCode": "32963-2310",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "732-801-8139",
"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "1480 HIGHWAY A1A",
"SecondLinePracticeLocationAddress": "FRIES PROFESSIONAL BUILDING",
"PracticeLocationAddressCityName": "VERO BEACH",
"PracticeLocationAddressStateName": "FL",
"PracticeLocationAddressPostalCode": "32963-2310",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "732-801-8139",
"PracticeLocationAddressFaxNumber": null,
"EnumerationDate": "06/01/2013",
"LastUpdateDate": "06/01/2013",
"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": "207X00000X",
"TaxonomyName": "Orthopaedic Surgery Physician",
"LicenseNumber": "0064060",
"LicenseNumberStateCode": "FL",
"PrimaryTaxonomySwitch": "Y"
},
{
"TaxonomyCode": "207X00000X",
"TaxonomyName": "Orthopaedic Surgery Physician",
"LicenseNumber": "MA 032823",
"LicenseNumberStateCode": "NJ",
"PrimaryTaxonomySwitch": "N"
},
{
"TaxonomyCode": "207X00000X",
"TaxonomyName": "Orthopaedic Surgery Physician",
"LicenseNumber": "97-00430",
"LicenseNumberStateCode": "NC",
"PrimaryTaxonomySwitch": "N"
}
]
},
"HealthcareProviderTaxonomyGroups": null
}
}