{
"Npi": {
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"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "I CARE OPTICAL, INC.",
"LastName": null,
"FirstName": null,
"MiddleName": null,
"NamePrefix": null,
"NameSuffix": null,
"Credential": null,
"OtherOrgName": null,
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"OtherLastName": null,
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"OtherNamePrefix": null,
"OtherNameSuffix": null,
"OtherCredential": null,
"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "PO BOX 22689",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "JACKSON",
"MailingAddressStateName": "MS",
"MailingAddressPostalCode": "39225-2689",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "601-352-3576",
"MailingAddressFaxNumber": "601-352-0290",
"FirstLinePracticeLocationAddress": "2526 16TH AVE",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "GULFPORT",
"PracticeLocationAddressStateName": "MS",
"PracticeLocationAddressPostalCode": "39501-3154",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "228-864-6175",
"PracticeLocationAddressFaxNumber": "228-864-6161",
"EnumerationDate": "02/06/2007",
"LastUpdateDate": "08/22/2020",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "LEACH",
"AuthorizedOfficialFirstName": "SANDRA",
"AuthorizedOfficialMiddleName": "W.",
"AuthorizedOfficialTitle": "VICE PRESIDENT",
"AuthorizedOfficialNamePrefix": "MRS.",
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": null,
"AuthorizedOfficialTelephoneNumber": "601-352-3576",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "332H00000X",
"TaxonomyName": "Eyewear Supplier",
"LicenseNumber": null,
"LicenseNumberStateCode": null,
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}