{
"Npi": {
"NPI": "1548391337",
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"EIN": null,
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"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "C B MCINNISH, OD PA",
"LastName": null,
"FirstName": null,
"MiddleName": null,
"NamePrefix": null,
"NameSuffix": null,
"Credential": null,
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"OtherOrgNameTypeCode": null,
"OtherLastName": null,
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"OtherNamePrefix": null,
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"OtherCredential": null,
"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "PO BOX 1268",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "BREWTON",
"MailingAddressStateName": "AL",
"MailingAddressPostalCode": "36427-1268",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "251-867-3635",
"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "106 W JACKSON ST",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "BREWTON",
"PracticeLocationAddressStateName": "AL",
"PracticeLocationAddressPostalCode": "36426-1516",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "251-867-3635",
"PracticeLocationAddressFaxNumber": null,
"EnumerationDate": "03/07/2007",
"LastUpdateDate": "04/08/2008",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "MCINNISH",
"AuthorizedOfficialFirstName": "CARL",
"AuthorizedOfficialMiddleName": "BYRON",
"AuthorizedOfficialTitle": "OWNER",
"AuthorizedOfficialNamePrefix": "DR.",
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "OD, PA",
"AuthorizedOfficialTelephoneNumber": "251-867-3635",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "152W00000X",
"TaxonomyName": "Optometrist",
"LicenseNumber": "S-312-TA-059",
"LicenseNumberStateCode": "AL",
"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."
}
}
}
}