{
"Npi": {
"NPI": "1598869646",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "PAJKA EYE CENTER INC",
"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": "855 W MARKET ST",
"SecondLineMailingAddress": "STE A",
"MailingAddressCityName": "LIMA",
"MailingAddressStateName": "OH",
"MailingAddressPostalCode": "45805",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "419-228-7432",
"MailingAddressFaxNumber": "419-228-5628",
"FirstLinePracticeLocationAddress": "200 ST CLAIR",
"SecondLinePracticeLocationAddress": "JOINT TOWNSHIP DISTRICT MEMORIAL HOSPITAL",
"PracticeLocationAddressCityName": "ST MARYS",
"PracticeLocationAddressStateName": "OH",
"PracticeLocationAddressPostalCode": "45885",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "419-228-7432",
"PracticeLocationAddressFaxNumber": "419-228-5628",
"EnumerationDate": "09/11/2006",
"LastUpdateDate": "08/22/2020",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "PAJKA",
"AuthorizedOfficialFirstName": "JOHN",
"AuthorizedOfficialMiddleName": "T",
"AuthorizedOfficialTitle": "OWNER/PRESIDENT",
"AuthorizedOfficialNamePrefix": null,
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "MD",
"AuthorizedOfficialTelephoneNumber": "419-228-7432",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "207W00000X",
"TaxonomyName": "Ophthalmology Physician",
"LicenseNumber": null,
"LicenseNumberStateCode": null,
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": {
"HealthcareProviderTaxonomyGroup": {
"HealthcareProviderTaxonomyGroupName": "193200000X MULTI-SPECIALTY GROUP",
"HealthcareProviderTaxonomyGroupDescription": "Multi-Specialty Group - A business group of one or more individual practitioners, who practice with different areas of specialization."
}
}
}
}