{
"Npi": {
"NPI": "1013281104",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "TYLER M. AMOS O.D., P.C.",
"LastName": null,
"FirstName": null,
"MiddleName": null,
"NamePrefix": null,
"NameSuffix": null,
"Credential": null,
"OtherOrgName": null,
"OtherOrgNameTypeCode": null,
"OtherLastName": null,
"OtherFirstName": null,
"OtherMiddleName": null,
"OtherNamePrefix": null,
"OtherNameSuffix": null,
"OtherCredential": null,
"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "184 OLD HIGHWAY 431",
"SecondLineMailingAddress": "SUITE C",
"MailingAddressCityName": "OWENS CROSS ROADS",
"MailingAddressStateName": "AL",
"MailingAddressPostalCode": "35763-9281",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "256-469-6073",
"MailingAddressFaxNumber": "256-469-6085",
"FirstLinePracticeLocationAddress": "184 OLD HIGHWAY 431",
"SecondLinePracticeLocationAddress": "SUITE C",
"PracticeLocationAddressCityName": "OWENS CROSS ROADS",
"PracticeLocationAddressStateName": "AL",
"PracticeLocationAddressPostalCode": "35763-9281",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "256-469-6073",
"PracticeLocationAddressFaxNumber": "256-469-6085",
"EnumerationDate": "03/07/2012",
"LastUpdateDate": "09/11/2013",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "AMOS",
"AuthorizedOfficialFirstName": "TYLER",
"AuthorizedOfficialMiddleName": "MARK",
"AuthorizedOfficialTitle": "OPTOMETRIST/ OWNER",
"AuthorizedOfficialNamePrefix": "DR.",
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "O.D.",
"AuthorizedOfficialTelephoneNumber": "256-469-6073",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "152W00000X",
"TaxonomyName": "Optometrist",
"LicenseNumber": "S999TA565",
"LicenseNumberStateCode": "AL",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": {
"HealthcareProviderTaxonomyGroup": {
"HealthcareProviderTaxonomyGroupName": "193400000X SINGLE SPECIALTY GROUP",
"HealthcareProviderTaxonomyGroupDescription": "Single Specialty Group - A business group of one or more individual practitioners, all of who practice with the same area of specialization."
}
}
}
}