{
"Npi": {
"NPI": "1104819903",
"EntityType": "Individual",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": "N",
"IsOrgSubpart": null,
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": null,
"LastName": "PERRINE",
"FirstName": "JEANNE",
"MiddleName": "MARIE",
"NamePrefix": "DR.",
"NameSuffix": null,
"Credential": "O.D. PC",
"OtherOrgName": null,
"OtherOrgNameTypeCode": null,
"OtherLastName": null,
"OtherFirstName": null,
"OtherMiddleName": null,
"OtherNamePrefix": null,
"OtherNameSuffix": null,
"OtherCredential": null,
"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "501 PULLIAM ST SW",
"SecondLineMailingAddress": "SUITE 139",
"MailingAddressCityName": "ATLANTA",
"MailingAddressStateName": "GA",
"MailingAddressPostalCode": "30312-2755",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "404-589-8517",
"MailingAddressFaxNumber": "404-222-0174",
"FirstLinePracticeLocationAddress": "501 PULLIAM ST SW",
"SecondLinePracticeLocationAddress": "SUITE 139",
"PracticeLocationAddressCityName": "ATLANTA",
"PracticeLocationAddressStateName": "GA",
"PracticeLocationAddressPostalCode": "30312-2755",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "404-589-8517",
"PracticeLocationAddressFaxNumber": "404-222-0174",
"EnumerationDate": "08/26/2005",
"LastUpdateDate": "07/03/2012",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": "03/27/2006",
"NPIReactivationDate": "04/20/2006",
"GenderCode": "F",
"Gender": "Female",
"AuthorizedOfficialLastName": null,
"AuthorizedOfficialFirstName": null,
"AuthorizedOfficialMiddleName": null,
"AuthorizedOfficialTitle": null,
"AuthorizedOfficialNamePrefix": null,
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": null,
"AuthorizedOfficialTelephoneNumber": null,
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "152W00000X",
"TaxonomyName": "Optometrist",
"LicenseNumber": "OPT001112",
"LicenseNumberStateCode": "GA",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}