{
"Npi": {
"NPI": "1710129713",
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"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "G DERRIL GWINNER, O.D. L.L.C.",
"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": "PO BOX 268",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "LINCOLN",
"MailingAddressStateName": "KS",
"MailingAddressPostalCode": "67455-0268",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "785-524-5244",
"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "208 W LINCOLN AVE",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "LINCOLN",
"PracticeLocationAddressStateName": "KS",
"PracticeLocationAddressPostalCode": "67455-1920",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "785-524-5244",
"PracticeLocationAddressFaxNumber": null,
"EnumerationDate": "04/06/2009",
"LastUpdateDate": "04/06/2009",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "GWINNER",
"AuthorizedOfficialFirstName": "G.",
"AuthorizedOfficialMiddleName": "DERRIL",
"AuthorizedOfficialTitle": "OPTOMETRIST",
"AuthorizedOfficialNamePrefix": "MR.",
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "O.D.",
"AuthorizedOfficialTelephoneNumber": "785-472-3272",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "152W00000X",
"TaxonomyName": "Optometrist",
"LicenseNumber": "9613",
"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."
}
}
}
}