{
"Npi": {
"NPI": "1912000464",
"EntityType": "Individual",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": "Y",
"IsOrgSubpart": null,
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": null,
"LastName": "BEALS",
"FirstName": "SCOTT",
"MiddleName": "L",
"NamePrefix": null,
"NameSuffix": null,
"Credential": "D.O.",
"OtherOrgName": null,
"OtherOrgNameTypeCode": null,
"OtherLastName": null,
"OtherFirstName": null,
"OtherMiddleName": null,
"OtherNamePrefix": null,
"OtherNameSuffix": null,
"OtherCredential": null,
"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "4566 E HIGHWAY 20",
"SecondLineMailingAddress": "SUITE 101",
"MailingAddressCityName": "NICEVILLE",
"MailingAddressStateName": "FL",
"MailingAddressPostalCode": "32578-8838",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "850-897-7546",
"MailingAddressFaxNumber": "850-897-7547",
"FirstLinePracticeLocationAddress": "4566 E HIGHWAY 20",
"SecondLinePracticeLocationAddress": "SUITE 101",
"PracticeLocationAddressCityName": "NICEVILLE",
"PracticeLocationAddressStateName": "FL",
"PracticeLocationAddressPostalCode": "32578-8838",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "850-897-7546",
"PracticeLocationAddressFaxNumber": "850-897-7547",
"EnumerationDate": "09/07/2006",
"LastUpdateDate": "11/24/2014",
"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": "207ND0900X",
"TaxonomyName": "Dermatopathology Physician",
"LicenseNumber": "OS7143",
"LicenseNumberStateCode": "FL",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}