{
"Npi": {
"NPI": "1396912747",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "RANDALL R HOLLOWAY OD",
"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": "4 S NATIONAL AVE",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "FORT SCOTT",
"MailingAddressStateName": "KS",
"MailingAddressPostalCode": "66701-1309",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "620-223-0850",
"MailingAddressFaxNumber": "620-223-2464",
"FirstLinePracticeLocationAddress": "4 S NATIONAL AVE",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "FORT SCOTT",
"PracticeLocationAddressStateName": "KS",
"PracticeLocationAddressPostalCode": "66701-1309",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "620-223-0850",
"PracticeLocationAddressFaxNumber": "620-223-2464",
"EnumerationDate": "05/14/2008",
"LastUpdateDate": "12/27/2012",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "HOLLOWAY",
"AuthorizedOfficialFirstName": "RANDALL",
"AuthorizedOfficialMiddleName": "R",
"AuthorizedOfficialTitle": "OWNER",
"AuthorizedOfficialNamePrefix": "DR.",
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "OD",
"AuthorizedOfficialTelephoneNumber": "620-223-0850",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "152W00000X",
"TaxonomyName": "Optometrist",
"LicenseNumber": "KS11843",
"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."
}
}
}
}