{
"Npi": {
"NPI": "1255500757",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "GARY L BARNES OD OPTOMETRIC CORPORATION",
"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": "931 ANZA AVE STE B",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "VISTA",
"MailingAddressStateName": "CA",
"MailingAddressPostalCode": "92084-4531",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "760-758-3944",
"MailingAddressFaxNumber": "760-758-2063",
"FirstLinePracticeLocationAddress": "931 ANZA AVE STE B",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "VISTA",
"PracticeLocationAddressStateName": "CA",
"PracticeLocationAddressPostalCode": "92084-4531",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "760-758-3944",
"PracticeLocationAddressFaxNumber": "760-758-2063",
"EnumerationDate": "02/28/2008",
"LastUpdateDate": "07/22/2009",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "BARNES",
"AuthorizedOfficialFirstName": "GARY",
"AuthorizedOfficialMiddleName": "L",
"AuthorizedOfficialTitle": "PRESIDENT",
"AuthorizedOfficialNamePrefix": "DR.",
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "O.D.",
"AuthorizedOfficialTelephoneNumber": "760-758-3044",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "305R00000X",
"TaxonomyName": "Preferred Provider Organization",
"LicenseNumber": "5234",
"LicenseNumberStateCode": "CA",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}