{
"Npi": {
"NPI": "1609017276",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "MADISONVILLE DISCOUNT EYEWEAR",
"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": "401 MADISON SQUARE DR STE 30",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "MADISONVILLE",
"MailingAddressStateName": "KY",
"MailingAddressPostalCode": "42431-2774",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "270-452-2197",
"MailingAddressFaxNumber": "270-825-1026",
"FirstLinePracticeLocationAddress": "401 MADISON SQUARE DR STE 30",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "MADISONVILLE",
"PracticeLocationAddressStateName": "KY",
"PracticeLocationAddressPostalCode": "42431-2774",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "270-452-2197",
"PracticeLocationAddressFaxNumber": "270-825-1026",
"EnumerationDate": "03/11/2009",
"LastUpdateDate": "03/11/2009",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "DUKES",
"AuthorizedOfficialFirstName": "MEL",
"AuthorizedOfficialMiddleName": "LEN",
"AuthorizedOfficialTitle": "OWNER / OPTICAN",
"AuthorizedOfficialNamePrefix": "MR.",
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "OPTICAN",
"AuthorizedOfficialTelephoneNumber": "270-452-2197",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "332H00000X",
"TaxonomyName": "Eyewear Supplier",
"LicenseNumber": "1095",
"LicenseNumberStateCode": "KY",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}