{
"Npi": {
"NPI": "1609918390",
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"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "DAVID A NELSON OD PA LLC",
"LastName": null,
"FirstName": null,
"MiddleName": null,
"NamePrefix": null,
"NameSuffix": null,
"Credential": null,
"OtherOrgName": null,
"OtherOrgNameTypeCode": null,
"OtherLastName": null,
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"OtherCredential": null,
"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "4123 SW GAGE CENTER DR",
"SecondLineMailingAddress": "SUITE 126",
"MailingAddressCityName": "TOPEKA",
"MailingAddressStateName": "KS",
"MailingAddressPostalCode": "66604-1886",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "785-273-6717",
"MailingAddressFaxNumber": "785-228-2029",
"FirstLinePracticeLocationAddress": "4123 SW GAGE CENTER DR",
"SecondLinePracticeLocationAddress": "SUITE 126",
"PracticeLocationAddressCityName": "TOPEKA",
"PracticeLocationAddressStateName": "KS",
"PracticeLocationAddressPostalCode": "66604-1886",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "785-273-6717",
"PracticeLocationAddressFaxNumber": "785-228-2029",
"EnumerationDate": "02/12/2007",
"LastUpdateDate": "02/15/2012",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "NELSON",
"AuthorizedOfficialFirstName": "DAVID",
"AuthorizedOfficialMiddleName": "A",
"AuthorizedOfficialTitle": "OWNER",
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"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "OD",
"AuthorizedOfficialTelephoneNumber": "785-273-6717",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "152W00000X",
"TaxonomyName": "Optometrist",
"LicenseNumber": "1357-3",
"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."
}
}
}
}