{
"Npi": {
"NPI": "1306865282",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "PAUL NIEGSCH OD LLC",
"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": "PO BOX 186",
"SecondLineMailingAddress": "101 N BROADWAY STE A",
"MailingAddressCityName": "PITTSBURG",
"MailingAddressStateName": "KS",
"MailingAddressPostalCode": "66762-0186",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "620-232-3277",
"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "101 N BROADWAY ST STE A",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "PITTSBURG",
"PracticeLocationAddressStateName": "KS",
"PracticeLocationAddressPostalCode": "66762-4804",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "620-232-3277",
"PracticeLocationAddressFaxNumber": null,
"EnumerationDate": "07/19/2006",
"LastUpdateDate": "12/15/2022",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "NIEGSCH",
"AuthorizedOfficialFirstName": "PAUL",
"AuthorizedOfficialMiddleName": null,
"AuthorizedOfficialTitle": "OWNER",
"AuthorizedOfficialNamePrefix": "DR.",
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "O D",
"AuthorizedOfficialTelephoneNumber": "620-232-3277",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "152W00000X",
"TaxonomyName": "Optometrist",
"LicenseNumber": "1242-3",
"LicenseNumberStateCode": "KS",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": {
"HealthcareProviderTaxonomyGroup": {
"HealthcareProviderTaxonomyGroupName": "193400000X 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."
}
}
}
}