{
"Npi": {
"NPI": "1053595736",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "DR CRYSTAL S HEFNER",
"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": "PO BOX 582",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "CONOVER",
"MailingAddressStateName": "NC",
"MailingAddressPostalCode": "28613-0582",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "828-464-6030",
"MailingAddressFaxNumber": "828-465-6339",
"FirstLinePracticeLocationAddress": "130 1ST ST W",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "CONOVER",
"PracticeLocationAddressStateName": "NC",
"PracticeLocationAddressPostalCode": "28613-2106",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "828-464-6030",
"PracticeLocationAddressFaxNumber": "828-465-6339",
"EnumerationDate": "12/18/2007",
"LastUpdateDate": "12/18/2007",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "HEFNER",
"AuthorizedOfficialFirstName": "CRYSTAL",
"AuthorizedOfficialMiddleName": "S",
"AuthorizedOfficialTitle": "OWNER",
"AuthorizedOfficialNamePrefix": null,
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "O.D.",
"AuthorizedOfficialTelephoneNumber": "828-464-6030",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "332H00000X",
"TaxonomyName": "Eyewear Supplier",
"LicenseNumber": "NC0990",
"LicenseNumberStateCode": "NC",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}