{
"Npi": {
"NPI": "1457516379",
"EntityType": "Individual",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": "Y",
"IsOrgSubpart": null,
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": null,
"LastName": "EDEN",
"FirstName": "HENRY",
"MiddleName": "SPENCER",
"NamePrefix": "DR.",
"NameSuffix": null,
"Credential": "MD",
"OtherOrgName": null,
"OtherOrgNameTypeCode": null,
"OtherLastName": null,
"OtherFirstName": null,
"OtherMiddleName": null,
"OtherNamePrefix": null,
"OtherNameSuffix": null,
"OtherCredential": null,
"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "3006 NOVAK TERRACE",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "BURTONSVILLE",
"MailingAddressStateName": "MD",
"MailingAddressPostalCode": "20866",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "301-421-0023",
"MailingAddressFaxNumber": "301-421-0010",
"FirstLinePracticeLocationAddress": "BUILDING 13 ROOM 3N17 MSC #5766",
"SecondLinePracticeLocationAddress": "NIH",
"PracticeLocationAddressCityName": "BETHESDA",
"PracticeLocationAddressStateName": "MD",
"PracticeLocationAddressPostalCode": "20892",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "301-435-1953",
"PracticeLocationAddressFaxNumber": "301-421-0010",
"EnumerationDate": "07/21/2008",
"LastUpdateDate": "07/21/2008",
"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": "208D00000X",
"TaxonomyName": "General Practice Physician",
"LicenseNumber": "D12777",
"LicenseNumberStateCode": "MD",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}