{
"Npi": {
"NPI": "1609975614",
"EntityType": "Individual",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": "N",
"IsOrgSubpart": null,
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": null,
"LastName": "HERRMANN",
"FirstName": "ALICIA",
"MiddleName": null,
"NamePrefix": "DR.",
"NameSuffix": null,
"Credential": "O.D.",
"OtherOrgName": null,
"OtherOrgNameTypeCode": null,
"OtherLastName": "TAYLOR",
"OtherFirstName": "ALICIA",
"OtherMiddleName": "HERRMANN",
"OtherNamePrefix": null,
"OtherNameSuffix": null,
"OtherCredential": "O.D.",
"OtherLastNameTypeCode": "2",
"FirstLineMailingAddress": "PO BOX 207170",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "DALLAS",
"MailingAddressStateName": "TX",
"MailingAddressPostalCode": "75320-7156",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "636-200-4393",
"MailingAddressFaxNumber": "636-527-0766",
"FirstLinePracticeLocationAddress": "10232 WESTPORT RD",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "LOUISVILLE",
"PracticeLocationAddressStateName": "KY",
"PracticeLocationAddressPostalCode": "40241-2148",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "502-339-2042",
"PracticeLocationAddressFaxNumber": "502-339-2044",
"EnumerationDate": "09/22/2006",
"LastUpdateDate": "10/06/2020",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": "F",
"Gender": "Female",
"AuthorizedOfficialLastName": null,
"AuthorizedOfficialFirstName": null,
"AuthorizedOfficialMiddleName": null,
"AuthorizedOfficialTitle": null,
"AuthorizedOfficialNamePrefix": null,
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": null,
"AuthorizedOfficialTelephoneNumber": null,
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "152W00000X",
"TaxonomyName": "Optometrist",
"LicenseNumber": "1266DT",
"LicenseNumberStateCode": "KY",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}