{
"Npi": {
"NPI": "1225287683",
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"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "EYE HEALTH SERVICES, INC",
"LastName": null,
"FirstName": null,
"MiddleName": null,
"NamePrefix": null,
"NameSuffix": null,
"Credential": null,
"OtherOrgName": null,
"OtherOrgNameTypeCode": null,
"OtherLastName": null,
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"OtherCredential": null,
"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "1900 CROWN COLONY DR",
"SecondLineMailingAddress": "SUITE 301",
"MailingAddressCityName": "QUINCY",
"MailingAddressStateName": "MA",
"MailingAddressPostalCode": "02169-0979",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "617-472-5242",
"MailingAddressFaxNumber": "617-770-2975",
"FirstLinePracticeLocationAddress": "1 COMPASS WAY",
"SecondLinePracticeLocationAddress": "SUITE 100",
"PracticeLocationAddressCityName": "EAST BRIDGEWATER",
"PracticeLocationAddressStateName": "MA",
"PracticeLocationAddressPostalCode": "02333-1465",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "877-331-3937",
"PracticeLocationAddressFaxNumber": "508-350-2813",
"EnumerationDate": "09/10/2008",
"LastUpdateDate": "06/24/2013",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "WASSON",
"AuthorizedOfficialFirstName": "PAUL",
"AuthorizedOfficialMiddleName": "J",
"AuthorizedOfficialTitle": "CLERK",
"AuthorizedOfficialNamePrefix": "DR.",
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "M.D.",
"AuthorizedOfficialTelephoneNumber": "617-472-5242",
"Taxonomies": {
"Taxonomy": [
{
"TaxonomyCode": "156FX1800X",
"TaxonomyName": "Optician",
"LicenseNumber": "4295",
"LicenseNumberStateCode": "MA",
"PrimaryTaxonomySwitch": "N"
},
{
"TaxonomyCode": "332H00000X",
"TaxonomyName": "Eyewear Supplier",
"LicenseNumber": null,
"LicenseNumberStateCode": null,
"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."
}
}
}
}