{
"Npi": {
"NPI": "1699374348",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "Y",
"ParentOrgLBN": "SAIRA KHAN OD PLLC",
"ParentOrgTIN": null,
"OrgName": "SAIRA KHAN OD PLLC",
"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": "32406 FRANKLIN RD UNIT 250125",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "FRANKLIN",
"MailingAddressStateName": "MI",
"MailingAddressPostalCode": "48025-7004",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "630-276-6285",
"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "28804 GRATIOT AVE",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "ROSEVILLE",
"PracticeLocationAddressStateName": "MI",
"PracticeLocationAddressPostalCode": "48066-4235",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "586-777-3434",
"PracticeLocationAddressFaxNumber": "586-777-6815",
"EnumerationDate": "10/23/2020",
"LastUpdateDate": "10/23/2020",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "KHAN",
"AuthorizedOfficialFirstName": "SAIRA",
"AuthorizedOfficialMiddleName": "NISHATH",
"AuthorizedOfficialTitle": "OPTOMETRIST",
"AuthorizedOfficialNamePrefix": "DR.",
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "O.D.",
"AuthorizedOfficialTelephoneNumber": "630-276-6285",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "152W00000X",
"TaxonomyName": "Optometrist",
"LicenseNumber": null,
"LicenseNumberStateCode": null,
"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."
}
}
}
}