{
"Npi": {
"NPI": "1518975226",
"EntityType": "Individual",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": "N",
"IsOrgSubpart": null,
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": null,
"LastName": "MELLOR",
"FirstName": "JEFFERY",
"MiddleName": "LOVELL",
"NamePrefix": "DR.",
"NameSuffix": null,
"Credential": "O.D., M.ED.",
"OtherOrgName": null,
"OtherOrgNameTypeCode": null,
"OtherLastName": null,
"OtherFirstName": null,
"OtherMiddleName": null,
"OtherNamePrefix": null,
"OtherNameSuffix": null,
"OtherCredential": null,
"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "15037 WINGED BLUFF LN",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "DRAPER",
"MailingAddressStateName": "UT",
"MailingAddressPostalCode": "84020-5719",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "801-649-3692",
"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "10412 S 2200 W",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "SOUTH JORDAN",
"PracticeLocationAddressStateName": "UT",
"PracticeLocationAddressPostalCode": "84095-8333",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "801-858-2020",
"PracticeLocationAddressFaxNumber": "801-610-2138",
"EnumerationDate": "08/04/2006",
"LastUpdateDate": "06/30/2022",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": "M",
"Gender": "Male",
"AuthorizedOfficialLastName": null,
"AuthorizedOfficialFirstName": null,
"AuthorizedOfficialMiddleName": null,
"AuthorizedOfficialTitle": null,
"AuthorizedOfficialNamePrefix": null,
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": null,
"AuthorizedOfficialTelephoneNumber": null,
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "152W00000X",
"TaxonomyName": "Optometrist",
"LicenseNumber": "328094-9934",
"LicenseNumberStateCode": "UT",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}