{
"Npi": {
"NPI": "1265533327",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "TIMOTHY J. PERRY, O.D., P.C.",
"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": "3856 STRATFORD CIR",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "VALDOSTA",
"MailingAddressStateName": "GA",
"MailingAddressPostalCode": "31605-4855",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "229-245-7227",
"MailingAddressFaxNumber": "229-244-5287",
"FirstLinePracticeLocationAddress": "120 BENJAMIN H HILL DR W",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "FITZGERALD",
"PracticeLocationAddressStateName": "GA",
"PracticeLocationAddressPostalCode": "31750-8607",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "229-423-0159",
"PracticeLocationAddressFaxNumber": "229-423-0165",
"EnumerationDate": "09/25/2006",
"LastUpdateDate": "09/18/2007",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "PERRY",
"AuthorizedOfficialFirstName": "TIMOTHY",
"AuthorizedOfficialMiddleName": "JAY",
"AuthorizedOfficialTitle": "PRESIDENT",
"AuthorizedOfficialNamePrefix": "DR.",
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "O.D.",
"AuthorizedOfficialTelephoneNumber": "229-245-7227",
"Taxonomies": {
"Taxonomy": [
{
"TaxonomyCode": "152W00000X",
"TaxonomyName": "Optometrist",
"LicenseNumber": "030/0000165",
"LicenseNumberStateCode": "VT",
"PrimaryTaxonomySwitch": "N"
},
{
"TaxonomyCode": "152W00000X",
"TaxonomyName": "Optometrist",
"LicenseNumber": "OPT001635",
"LicenseNumberStateCode": "GA",
"PrimaryTaxonomySwitch": "Y"
}
]
},
"HealthcareProviderTaxonomyGroups": {
"HealthcareProviderTaxonomyGroup": [
{
"HealthcareProviderTaxonomyGroupName": "193400000X MULTIPLE 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."
},
{
"HealthcareProviderTaxonomyGroupName": "193400000X MULTIPLE 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."
}
]
}
}
}