{
"Npi": {
"NPI": "1285891507",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "DAVID C BURGER OPTICAL",
"LastName": null,
"FirstName": null,
"MiddleName": null,
"NamePrefix": null,
"NameSuffix": null,
"Credential": null,
"OtherOrgName": null,
"OtherOrgNameTypeCode": "6",
"OtherLastName": null,
"OtherFirstName": null,
"OtherMiddleName": null,
"OtherNamePrefix": null,
"OtherNameSuffix": null,
"OtherCredential": null,
"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "1459 E DOROTHY LN",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "KETTERING",
"MailingAddressStateName": "OH",
"MailingAddressPostalCode": "45429-3805",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "937-294-6715",
"MailingAddressFaxNumber": "937-294-3955",
"FirstLinePracticeLocationAddress": "1459 E DOROTHY LN",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "KETTERING",
"PracticeLocationAddressStateName": "OH",
"PracticeLocationAddressPostalCode": "45429-3805",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "937-294-6715",
"PracticeLocationAddressFaxNumber": "937-294-3955",
"EnumerationDate": "05/22/2008",
"LastUpdateDate": "05/22/2008",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "BURGER",
"AuthorizedOfficialFirstName": "DAVID",
"AuthorizedOfficialMiddleName": "C",
"AuthorizedOfficialTitle": "OWNER",
"AuthorizedOfficialNamePrefix": "MR.",
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "OPTICIAN",
"AuthorizedOfficialTelephoneNumber": "937-294-6715",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "332H00000X",
"TaxonomyName": "Eyewear Supplier",
"LicenseNumber": "3288 SC",
"LicenseNumberStateCode": "OH",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}