{
"Npi": {
"NPI": "1568625804",
"EntityType": "Individual",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": "N",
"IsOrgSubpart": null,
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": null,
"LastName": "FREIER",
"FirstName": "RICHARD",
"MiddleName": "DAVIS",
"NamePrefix": null,
"NameSuffix": "II",
"Credential": "MD",
"OtherOrgName": null,
"OtherOrgNameTypeCode": null,
"OtherLastName": null,
"OtherFirstName": null,
"OtherMiddleName": null,
"OtherNamePrefix": null,
"OtherNameSuffix": null,
"OtherCredential": null,
"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "1005 MAR WALT DRIVE",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "FORT WALTON BEACH",
"MailingAddressStateName": "FL",
"MailingAddressPostalCode": "32547-6707",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "850-863-8100",
"MailingAddressFaxNumber": "850-863-8548",
"FirstLinePracticeLocationAddress": "8990 NAVARRE PARKWAY",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "NAVARRE",
"PracticeLocationAddressStateName": "FL",
"PracticeLocationAddressPostalCode": "32566-2216",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "850-396-0108",
"PracticeLocationAddressFaxNumber": "850-939-4933",
"EnumerationDate": "07/08/2008",
"LastUpdateDate": "07/03/2019",
"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": "207Q00000X",
"TaxonomyName": "Family Medicine Physician",
"LicenseNumber": "ME111391",
"LicenseNumberStateCode": "FL",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}