{
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"FirstLineMailingAddress": "4516 E HIGHWAY 20 # 108",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "NICEVILLE",
"MailingAddressStateName": "FL",
"MailingAddressPostalCode": "32578-9755",
"MailingAddressCountryCode": "US",
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"FirstLinePracticeLocationAddress": "4516 E HIGHWAY 20 # 108",
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"PracticeLocationAddressCityName": "NICEVILLE",
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"PracticeLocationAddressTelephoneNumber": "251-533-5457",
"PracticeLocationAddressFaxNumber": "414-626-6341",
"EnumerationDate": "04/16/2020",
"LastUpdateDate": "04/16/2020",
"NPIDeactivationReasonCode": null,
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"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "SCOTT",
"AuthorizedOfficialFirstName": "FRANK",
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"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "207RN0300X",
"TaxonomyName": "Nephrology Physician",
"LicenseNumber": null,
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"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."
}
}
}
}