{
"Npi": {
"NPI": "1053511147",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "VERMONT OPTICAL CORP",
"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": "69 ALLEN ST",
"SecondLineMailingAddress": "SUITE 15",
"MailingAddressCityName": "RUTLAND",
"MailingAddressStateName": "VT",
"MailingAddressPostalCode": "05701-4564",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "802-774-5124",
"MailingAddressFaxNumber": "802-774-5129",
"FirstLinePracticeLocationAddress": "69 ALLEN ST",
"SecondLinePracticeLocationAddress": "SUITE 15",
"PracticeLocationAddressCityName": "RUTLAND",
"PracticeLocationAddressStateName": "VT",
"PracticeLocationAddressPostalCode": "05701-4564",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "802-774-5124",
"PracticeLocationAddressFaxNumber": "802-774-5129",
"EnumerationDate": "07/18/2007",
"LastUpdateDate": "01/02/2013",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "BIRAJICLIAN",
"AuthorizedOfficialFirstName": "GREGORY",
"AuthorizedOfficialMiddleName": "CHANDLER",
"AuthorizedOfficialTitle": "PRESIDENT",
"AuthorizedOfficialNamePrefix": "MR.",
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "OPTICIAN",
"AuthorizedOfficialTelephoneNumber": "802-774-5124",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "332H00000X",
"TaxonomyName": "Eyewear Supplier",
"LicenseNumber": "028-0000350",
"LicenseNumberStateCode": "VT",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}