{
"Npi": {
"NPI": "1073772828",
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"EIN": null,
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"IsOrgSubpart": "N",
"ParentOrgLBN": null,
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"OrgName": "MOUNTAIN EYE CLINIC, PC",
"LastName": null,
"FirstName": null,
"MiddleName": null,
"NamePrefix": null,
"NameSuffix": null,
"Credential": null,
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"OtherLastName": null,
"OtherFirstName": null,
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"OtherCredential": null,
"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "431 GROVE ST N",
"SecondLineMailingAddress": "SUITE C",
"MailingAddressCityName": "DAHLONEGA",
"MailingAddressStateName": "GA",
"MailingAddressPostalCode": "30533-0437",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "706-864-8635",
"MailingAddressFaxNumber": "706-864-2441",
"FirstLinePracticeLocationAddress": "431 GROVE ST N",
"SecondLinePracticeLocationAddress": "SUITE C",
"PracticeLocationAddressCityName": "DAHLONEGA",
"PracticeLocationAddressStateName": "GA",
"PracticeLocationAddressPostalCode": "30533-0437",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "706-864-8635",
"PracticeLocationAddressFaxNumber": "706-864-2441",
"EnumerationDate": "06/06/2008",
"LastUpdateDate": "02/27/2013",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "JABALEY",
"AuthorizedOfficialFirstName": "RICHARD",
"AuthorizedOfficialMiddleName": "G",
"AuthorizedOfficialTitle": "OPTOMETRIST/OWNER",
"AuthorizedOfficialNamePrefix": "MR.",
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "O.D.",
"AuthorizedOfficialTelephoneNumber": "706-864-8635",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "152W00000X",
"TaxonomyName": "Optometrist",
"LicenseNumber": "OPT001389",
"LicenseNumberStateCode": "GA",
"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."
}
}
}
}