{
"Npi": {
"NPI": "1376612135",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "JOHN M. PRICE OD, INC.",
"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": "113 NORTH FIRST ST.",
"SecondLineMailingAddress": "P.O. BOX 168",
"MailingAddressCityName": "OAKWOOD",
"MailingAddressStateName": "OH",
"MailingAddressPostalCode": "45873",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "419-594-3340",
"MailingAddressFaxNumber": "419-594-3300",
"FirstLinePracticeLocationAddress": "113 NORTH FIRST ST.",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "OAKWOOD",
"PracticeLocationAddressStateName": "OH",
"PracticeLocationAddressPostalCode": "45873",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "419-594-3340",
"PracticeLocationAddressFaxNumber": "419-594-3300",
"EnumerationDate": "11/07/2006",
"LastUpdateDate": "01/13/2012",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "WINE",
"AuthorizedOfficialFirstName": "CLARINDA",
"AuthorizedOfficialMiddleName": "Y",
"AuthorizedOfficialTitle": "OFFICE MANAGER",
"AuthorizedOfficialNamePrefix": "MRS.",
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "L.D.O.",
"AuthorizedOfficialTelephoneNumber": "419-594-3340",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "152W00000X",
"TaxonomyName": "Optometrist",
"LicenseNumber": "5062",
"LicenseNumberStateCode": "OH",
"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."
}
}
}
}