{
"Npi": {
"NPI": "1063836625",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "SCHOTT VISION CARE PA",
"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": "600 S ORLANDO AVE",
"SecondLineMailingAddress": "SUITE 300",
"MailingAddressCityName": "MAITLAND",
"MailingAddressStateName": "FL",
"MailingAddressPostalCode": "32751-5660",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "407-647-2020",
"MailingAddressFaxNumber": "407-628-1216",
"FirstLinePracticeLocationAddress": "600 S ORLANDO AVE",
"SecondLinePracticeLocationAddress": "SUITE 300",
"PracticeLocationAddressCityName": "MAITLAND",
"PracticeLocationAddressStateName": "FL",
"PracticeLocationAddressPostalCode": "32751-5660",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "407-647-2020",
"PracticeLocationAddressFaxNumber": "407-628-1216",
"EnumerationDate": "02/18/2014",
"LastUpdateDate": "08/08/2014",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "SCHOTT",
"AuthorizedOfficialFirstName": "RYAN",
"AuthorizedOfficialMiddleName": "WAYNE",
"AuthorizedOfficialTitle": "DIRECTOR",
"AuthorizedOfficialNamePrefix": "DR.",
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "O.D.",
"AuthorizedOfficialTelephoneNumber": "407-647-2020",
"Taxonomies": {
"Taxonomy": [
{
"TaxonomyCode": "152WL0500X",
"TaxonomyName": "Low Vision Rehabilitation Optometrist",
"LicenseNumber": "OPC1011",
"LicenseNumberStateCode": "FL",
"PrimaryTaxonomySwitch": "N"
},
{
"TaxonomyCode": "152W00000X",
"TaxonomyName": "Optometrist",
"LicenseNumber": "OPC4666",
"LicenseNumberStateCode": "FL",
"PrimaryTaxonomySwitch": "Y"
}
]
},
"HealthcareProviderTaxonomyGroups": {
"HealthcareProviderTaxonomyGroup": [
{
"HealthcareProviderTaxonomyGroupName": "193200000X MULTI-SPECIALTY GROUP",
"HealthcareProviderTaxonomyGroupDescription": "Multi-Specialty Group - A business group of one or more individual practitioners, who practice with different areas of specialization."
},
{
"HealthcareProviderTaxonomyGroupName": "193200000X MULTI-SPECIALTY GROUP",
"HealthcareProviderTaxonomyGroupDescription": "Multi-Specialty Group - A business group of one or more individual practitioners, who practice with different areas of specialization."
}
]
}
}
}