{
"Npi": {
"NPI": "1194955310",
"EntityType": "Individual",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": "N",
"IsOrgSubpart": null,
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": null,
"LastName": "COZZI",
"FirstName": "NANCY",
"MiddleName": null,
"NamePrefix": "DR.",
"NameSuffix": null,
"Credential": "O.D.",
"OtherOrgName": null,
"OtherOrgNameTypeCode": null,
"OtherLastName": null,
"OtherFirstName": null,
"OtherMiddleName": null,
"OtherNamePrefix": null,
"OtherNameSuffix": null,
"OtherCredential": null,
"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "4602 NEW MILFORD RD",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "ROOTSTOWN",
"MailingAddressStateName": "OH",
"MailingAddressPostalCode": "44272-9780",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "314-477-7278",
"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "512 CANTON RD",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "AKRON",
"PracticeLocationAddressStateName": "OH",
"PracticeLocationAddressPostalCode": "44312-2530",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "330-784-1155",
"PracticeLocationAddressFaxNumber": null,
"EnumerationDate": "07/22/2009",
"LastUpdateDate": "08/05/2022",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"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": "2009020663",
"LicenseNumberStateCode": "MO",
"PrimaryTaxonomySwitch": "N"
},
{
"TaxonomyCode": "152W00000X",
"TaxonomyName": "Optometrist",
"LicenseNumber": "046.010230",
"LicenseNumberStateCode": "IL",
"PrimaryTaxonomySwitch": "N"
},
{
"TaxonomyCode": "152W00000X",
"TaxonomyName": "Optometrist",
"LicenseNumber": "6349",
"LicenseNumberStateCode": "OH",
"PrimaryTaxonomySwitch": "Y"
}
]
},
"HealthcareProviderTaxonomyGroups": null
}
}